A treatise on orthopedic surgery . led weak ankle or flat-foot, and with it is often asso-ciated a moderate degree of knock-knee. This may be pre-vented by a shoe of proper shape, of which the heel and sole arethickened slightly on the inner side. CHAPTER II. NON-TUBERCULOUS AFFECTIONS OF THE SPINE. SYPHILIS. Syphilis^ in the inherited or in the later stages of the ac-quired form, may affect the bones of the spine and cause local deformity and symptoms that can-not be distinguished from those ofPotts disease. Diagnosis.—As compared withtuberculosis it is a rare disease ofthe spine.^ Its manife
A treatise on orthopedic surgery . led weak ankle or flat-foot, and with it is often asso-ciated a moderate degree of knock-knee. This may be pre-vented by a shoe of proper shape, of which the heel and sole arethickened slightly on the inner side. CHAPTER II. NON-TUBERCULOUS AFFECTIONS OF THE SPINE. SYPHILIS. Syphilis^ in the inherited or in the later stages of the ac-quired form, may affect the bones of the spine and cause local deformity and symptoms that can-not be distinguished from those ofPotts disease. Diagnosis.—As compared withtuberculosis it is a rare disease ofthe spine.^ Its manifestations arelikely to be general in character,the deformity of the spine beingbut one of many evidences ofdisease. If syphilis were limited to thespine and simulated the symptomsand the deformity of Potts diseaseit would de^mand the same localtreatment. Specific remedies areindicated if one suspects the pres-ence of syphilitic taint, even if thelocal disease appears to be tubercu-lous in character. MALIGNANT DISEASE OF Vertical anteroposterior sectionof the lumbar spine, showing de-posit of gumma in the posteriorpart of the third and fourthvertebrae. (After Fournier.) Malignant disease of the spine is a rare affection, particularly so in childhood. Sarcoma is more common than carcinoma, and it may affect the spine primarily. Carcinoma is almost always secondary to a primary tumor elsewhere, the spine becoming involved by metastasis or by contiguity. Schlesinger- in 3720 cases of carcinoma found secondary growths in the spine in 54. 1 Jasinski, Archiv f. Dermat. u. Sypli., Bd. xxiii., S. , Journal of Nervous and Mental Disease, April, 1902. 128 NON-TUBEECULOUS AFFECTIONS OF THE SPINE. 129 Diagnosis.—Malignant disease differs from tuberculosis ofthe spine in that its symptoms are usually more severe; the painis usually persistent, and it is not relieved by support or recum-bency, as is that of Potts disease. The constitutional symptomsare more marked and
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