A treatise on orthopedic surgery . A, direct deformity; dotted line indicatestlie normal contour of thespine. 30 ORTHOPEDIC SUEGEBY. by Potts disease, but other than by calling attention to diseaseof the spine as a j)ossible cause of the complication, they do notaid one in determining the diag-nosis; for this reason they areclassed as secondary symptoms. General —Especial stress is laid by certain writers^^ipon the diagnostic value of a slight but constant elevation ofthe^temperature. This is usually present if the disease is activeor when an abscess is a
A treatise on orthopedic surgery . A, direct deformity; dotted line indicatestlie normal contour of thespine. 30 ORTHOPEDIC SUEGEBY. by Potts disease, but other than by calling attention to diseaseof the spine as a j)ossible cause of the complication, they do notaid one in determining the diag-nosis; for this reason they areclassed as secondary symptoms. General —Especial stress is laid by certain writers^^ipon the diagnostic value of a slight but constant elevation ofthe^temperature. This is usually present if the disease is activeor when an abscess is approaching the surface, but the positivevalue of the symptom in early or quiescent cases is may be assumed also that a patient suffering from tubercu-lous disease of the sj^ine will present some evidence of a painfuland depressing affection, or of inherited or acquired weakness;yet it must be remembered that the absence of such generalsymptoms would not exclude Potts disease. Fig. Normal contour and flexibility of the spine. The Contour and Flexibility of the Spine.—In the enumerationof the early symptoms of Potts disease, two have been notedas of especial importance-—the impairment of normal mobilityand the eifect of the disease upon the contour of the spine andupon the attitudes of the patient. Therefore, in the study ofnormal spine the standard with which that suspected of diseasemust be compared, mobility and contour, at different ages andunder different conditions should receive especial consideration. The sj^ine as a whole is a flexible column presenting certainconstant curves, forward in the upper, backward in the middle, TUBEECULOUS DISEASE OF THE SPINE. 31 and forward again in tbe lower region. These curves are essen-tially the effect of the force of gravity and of the action of themuscles in balancing the weight of the body in the upright atti-tude. In the adult they are practically fixed; in early childhoodthey can be nearly obliterated by tract
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