A treatise on orthopedic surgery . he Thomas collar applied. (Ridlon and Jones.) Many other forms of apparatus of greater or less merit mightbe described, but space has permitted only a detailed account ofthree forms that, it would seem, best represent the essentialprinciples involved in the treatment of Potts disease. The Principles of Treatment in Their Practical Application.—Theeffect of treatment must be estimated not simply by its reliefof the symptoms of the disease, since deformity may increasein spite of the apparent well-being of the patient, but it mustbe selected and continued or ch
A treatise on orthopedic surgery . he Thomas collar applied. (Ridlon and Jones.) Many other forms of apparatus of greater or less merit mightbe described, but space has permitted only a detailed account ofthree forms that, it would seem, best represent the essentialprinciples involved in the treatment of Potts disease. The Principles of Treatment in Their Practical Application.—Theeffect of treatment must be estimated not simply by its reliefof the symptoms of the disease, since deformity may increasein spite of the apparent well-being of the patient, but it mustbe selected and continued or changed with the aim of com- 104 OETHOPEDIC SUEGEEY. bating ultimate defonnitT, and on this standard success orfailure must be determined. Indications for Treatment by Recumbency.—As lias been statedalready, the most important influence toward deformity isthe force of gravity; therefore, horizontal fixation in overexten-sion is the most efficient means of preventing deformity, and ofassuring the rest that favors repair. Fig. Cervical Opistbotonos. It is indicated as the routine treatment in infancy and inearly childhood up to the age of four years at least. In many instances absolute recumbency may not be required,Imt the period of activity must be carefully regulated, and mustbe discontinued when there is evidence of discomfort or weak-ness or pain. If the period of activity must be short, it shouldbe passed in the open air. The passive attitude of sitting,although less strain is thrown upon the spine than duringactivity, may be even worse for the patient; thus, the recliningor semi-reclining posture should be assumed as a rule, when thechild is in the house, at least during the active stage of thedisease. Even if the spine apj^ears to be perfectly supported,the time spent in bed should be long, and a period of rest in themiddle of the dav should be enforced. TUBEBCULOUS DISEASE OF THE SPINE. 105 The arguments in favor of horizontal fixation in early child-hood do not a
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