A treatise on orthopedic surgery . other extremity ofthe spine, or the effect of muscular con-traction, or it may be due to simpleweakness, in which case it is a transientsymptom. Finally, even in incipient cases,there is almost always a slight changein the outline of the spine due to localrigidity; the spine no longer formsa long, regular curve when the bodyis bent forward, but the outline is bro-ken at or near the seat of the disease(Fig. 7). Secondary or Complicating Symptoms, (a) Abscess.,—This™^7? by its size or situation, cause peculiar symptoms. In theretropharyngeal space it may interf
A treatise on orthopedic surgery . other extremity ofthe spine, or the effect of muscular con-traction, or it may be due to simpleweakness, in which case it is a transientsymptom. Finally, even in incipient cases,there is almost always a slight changein the outline of the spine due to localrigidity; the spine no longer formsa long, regular curve when the bodyis bent forward, but the outline is bro-ken at or near the seat of the disease(Fig. 7). Secondary or Complicating Symptoms, (a) Abscess.,—This™^7? by its size or situation, cause peculiar symptoms. In theretropharyngeal space it may interfere with a respiration anddeglutition. In the thoracic region it might be mistaken forpleurisy or empyema, and when it forms a tumor in the iliacfossa it may interfere with locomotion. (b) Paralysis,-—This is usually a late symptom, but if thedisease begins in the centre or posterior part of a vertebral bodyit may implicate the spinal cord before deformity is apparent. Abscess and paralysis are symptoms that may be explained. 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. 6
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