Spinal caries : (spondylitis, or inflammatory disease of the spinal column.) / by Noble Smith.

  • Smith, E. Noble (Eldred Noble), 1847-1906.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Spinal caries : (spondylitis, or inflammatory disease of the spinal column.) / by Noble Smith. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    may be experienced. If in the lumbar region the pelvic viscera may show symptoms of nerve irritation. The discomfort at the epigastrimii is sometimes described by the patient as resembling the sensation of a cord tied tightly romid the body, or as a baud pressing firmly, but in very young children the symptoms of pain are less definite—a child may complain of stomach ache. Pain situated in the parietes is usually symmetrical, but not unfrequently it is on one side only. Pain is a very uncertain symptom, for it may vary much in degree. Exacerbation of pain commonly occurs suddenly in the night, and this may cause the patient, if a child, to utter a sharp cry. Pain may be entirely absent, or exist to such a slight degree that it is very easily attributed to other causes. The latter facts have certainly not received sufficient atten- tion, for the opinion is very prevalent that the absence of pain is positive evidence of absence of inflammatory disease of the spinal column. Pain is chiefly felt in the peripheries of the nerves proceed- ing from the spinal column. Thus uncomfortable sensations in the chest, abdomen, or pelvis, or legs, may be alone com- plained of, or the pains in these parts may be severe, while only a dull aching is felt in the back itself. It will often be found that the pain proceeds in the line of the spinal nerves, commencing near the spine and proceeding downwards and forwards to the front of the body, commencing to be more severe at the side or sides. A dull, aching pain in the immediate neighbourhood of the diseased vertebrae is fre- quently felt in acute cases, and this will often be increased by the patient bending the body forwards. If there is pain on firm pressure of the spinous processes or in their immediate neighbourhood, it may be acute, and is often complained of as a burning sensation. There is a pecu- liarity as regards pain from caries which sometimes is met with, especially with adults. Extra exertion will not produce immediate pain, and a patient may even feel better for a brisk walk, but a few hours afterwards the pain will occur and re- main for several hours, and probably until prolonged rest is obtained, such as rest in bed. Pain is usually relieved by rest, and is often absent in the morning after a good night's sleep, but commences soon after getting up and increases during the day.