Reviews and Notices of Books
593 general health and by the" guarded attitude " in which the spine was held ; the grunting respiration elicited by placing the child in a prone position across the knees was distinctive and more reliance should be placed on distal or radiating pains than on local pain. Muscular rigidity limited to a few vertebrae preceded the bony rigidity with general contraction of the spinal muscles. It was necessary not to confuse lateral curvature with posterior projection of the spinal processes with a
... l processes with a lateral curve due to unilateral caries of the vertebral bodies. In the matter of treatment it was pointed out that the case required a recumbent posture for years rather than months. He had been disappointed with the results of laminectomy for compression paraplegia, finding that recovery followed rest in most cases, while laminectomy was of little value except where pus could be evacuated. He was less inclined than formerly to treat abscesses by incision and drainage, preferring to close the wound and to treat it aseptically. The immediate reduction of spinal deformity by successive stretchings was of value, but owing to the great difficulty, especially in out-patient practice, of obtaining prolonged rest most cases relapsed. The differential diagnosis from rickety kyphosis was alluded to and models and drawings of apparatus were shown with photographs of various types of deformity. In dealing with the causes of lateral curvature attention was drawn to the influence of unequal legs, and the difficulty of diagnosis and treatment in cases of crossed asymmetry was , mentioned. The treatment fell under the four headings of rest, exercise, massage, and support. Two schools of treatment had arisen, by exercise and bv supports, but in the opinion of Mr. Tubby every case could not be I adequately treated by either method. Discretion must be used in the choice of treatment and in some both methods might be combined with advantage.. Deformed chests, spasmodic wryneck, and coxa vara were briefly referred to, the importance of prolonged rest in cases of osteotomy for genu valgum was insisted on, while the futility of operating in genu valgum of ligamentous origin was shown. The various forms of tlat-foot were discussed and explained, splints and supports of different kinds were shown, and the good result following the excision of an inch of the peroneal tendon in some cases was alluded to.