A treatise on orthopedic surgery . t be mistaken, during an acute exacerbationof the disease or constitutional disturbance from other cause,for pleurisy or empyema or even for phthisis. In all cases,therefore, a careful examination of the chest should be madefrom time to time in order that the presence or absence of ab-scess may be recorded. —Potts disease of the thoracic region is often in-sidious in its onset, causing no positive symptoms before thestage of deformity. Its most characteristic symptoms are pain referred to thefront and sides of the body and the grunting respiration. T
A treatise on orthopedic surgery . t be mistaken, during an acute exacerbationof the disease or constitutional disturbance from other cause,for pleurisy or empyema or even for phthisis. In all cases,therefore, a careful examination of the chest should be madefrom time to time in order that the presence or absence of ab-scess may be recorded. —Potts disease of the thoracic region is often in-sidious in its onset, causing no positive symptoms before thestage of deformity. Its most characteristic symptoms are pain referred to thefront and sides of the body and the grunting respiration. TUBEBCULOUS DISEASE OF THE SPINE. 57 If the disease is progressive, weakness and stiffness arepresent. The attitude, when the disease is in the lower thoracicregion, resembles that of Inmbar disease; if the upper part isaffected the head is tilted somewhat backward and the shouldersappear to be elevated. 2. Disease of the Upper Region.—The upper region of thespine, which includes the cervical and two of the dorsal ver- FiG. Cervical disease with abscess. Characteristic attitude. tebrse, corresponds in freedom of movement and in its contourto the lumbar region. From the functional standpoint it maybe divided into two parts. Of these, the superior or occipito-axoid section is peculiar, in that it contains no vertebral bodyor intervertebral cartilage, and in that the movements of thehead are carried out in special joints and are controlled byspecial muscles. Occipitoaxoid disease is relatively more fre-quent in adult life than in childhood and it is as compared todisease of other regions of the spine more dangerous because of 58 OBTEOPEDIC SURGERY. the proximity of the vital centers which may be injured bypressure or by sudden displacement of the weakened —In a typical case the symptoms are neuralgicpain radiating over the back and sides of the head, followingthe distribution of the auricular and occipital nerves. Theneck is stiff and the head may be f
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