Wqqd(;j:.4.) ?r jryyyyyTYyy YTYTYTy s-yyyY ffirYY1 POTT'S DISK ASK: ^nguiar Curbnture of tin .Spine. CASES SUCCESSFULLY TREATED -rfY J. A. WOOD, M.I.'> ii) II 1STON. MAS-. AN'!) IlKL^O.trKI) IX THE N'HW ViJlllv Joi'UXAL OF MHDICIXiv \'ovt*nili«-r, 1S57. ^m °< =■< °< °< °< <=< °< ■=< =>< °< =>< °< °< °< X K W V < > LI K : HKI.M.W. 11»>:<: avu .ion imivi':-:.!. r >:;•:: us v.<:\ \<.< w.t r-. sn:K;:i JLR.JlJLJlJlJlAJlAJlJl.'lJLAAJlXRXJLS.JlJlJUl.Af? POTT'S DISEASE; OK, ngnlar Cnrhtnre 0f \\t %hte. CASES SUCCESSFULLY TREATED BY J. A. WOOD, M.D., OF BOSTON, MAS?. AND REPORTED IN THE NEW YORK JOURNAL OF MEDICINE. November, 1857. 5/10 >' NEW YORK: HOLMAN. BOOK AND JOB PRINTER, CORNER OF ELM AND WHITE STREETS. 1857. POTT'S DISEASE; OR, ANGULAR CURVATURE OF THE SPINE. Having devoted my time and attention to the treatment of spinal diseases, as a specialty, for the last three years or more, examining closely the results that have followed, I now propose to show, by the report of cases which have been under my charge, that a cure in Pott's disease of the spine may not, per- haps, in all cases, "necessarily consist of curvature," as is generally maintained ; that the further progress of the curva- ture may generally be arrested from the time treatment is com- menced, and, in cases of recent character, a cure effected with the curvature nearly, if not completely, removed, by appropriate mechanical appliances principally, to the entire exclusion of setons, issues, or any other counter irritant, or even restricting the patient to the recumbent position. Case 1.—Master -y---, ast. 9 years, son of Dr. Lyman Bartlett, of New Bedford, Mass., w'as placed under my care for the treat- ment of angular curvature of the spine, December 14, 1855. The early history of this patient, as related to me, bore upon its face an unfavorable caste—three uncles, on the mother's side, having died in childhood of consumption, which they inherited from their mother, another victim of that treacherous disease. The patient, himself, exhibited early and repeated indications of premature decay, and, in the autumn of 1854, began to complain occasionally of pain in the left hip. In January, 1855, had an attack of croup, followed with severe 4 paroxysms of cough, which continued about three weeks, when an attack of measles supervened, of extreme severity. For three months following the attack of croup, little or no respiratory murmur was perceptible in the left lung. While recovering from the measles, the patient having occasion to get up in the night, it was ascertained that he could not stand upright, but was obliged to support himself by placing his hands upon his knees. This led to the discovery of a curvature of the spine, with a small knuckle, which was distinctly marked. The pain in the back and legs was severe, extending to the knees and ankles, and affecting other parts of the system ; the pain occurring at intervals, and the curvature continuing to in- crease from this up to the time I first saw the patient—some ten months after. The history, thus far, I obtained from the Dr. him- self, who is scrupulously exact in noting observations, and in the 'statement of facts. The disease had now existed more than a year, affecting, particularly, the three lower dorsal vertebras, producing a bold, angular projection of the spine backward, a pending and prominent abdomen, with a flattened chest. The lower extremi- ties were contracted and drawn up, the left about an inch shorter than the right, and any effort to extend them was painful to the patient. The pain was severe, the lower extremities nearly powerless, and but faint hopes had been entertained of a final recovery. He was now utterly unable to stand, and had not been dressed for nearly six months, wearied and worn, as this class of patients usually are, from pain and suffering and continued confinement. Treatment.—This consisted in the application of a spinal appa- ratus of recent invention, constructed and applied upon a new principle, nicely adjusted, and readjusted from time to time as the necessity of the case demanded. This afforded efficient and comfortable support to the spinal column, enabling the patient to resume, at once, the erect position and move about, cautiously at first, upon his feet, which he was permitted to do daily, as his strength and other circumstances would allow. Galvanism was applied by friction with the hand to the back and limbs once or twice a day, and continued for some length of time with the use of a free and generous diet. On the application of the apparatus the relief from pain was immediate and complete, and in a few weeks the lower extremities 0 were of equal length, and could be fully straightened without the least difficulty. The patient quickly recovered, has grown rapidly, and has since fully regained his vig- or, strength, and pow- ers of locomotion, in either of which he would not now ap- pear deficient in com- parison with others of his age. The accom- P parrying outlines of '.% the case were taken VS. by the Doctor at his / own suggestion, a gentlemen of high professional reputa- tion, who very kindly offered them to me, unsolicited, recom- mending their publi- cation as a matter of medical interest. The anterior and posterior dotted lines represent the precise form of the patient as exhibited December 20, 1855. The two shaded, or dark lines represent correctly the form of the patient, June 23, 1856 (six months after), with the curvature nearly obliterated, the abdomen less prominent with a full and capacious chest. It should be here observed, that the curvature since the last outline was taken, lias gradually diminished till nearly every trace of it has become extinct. Case 2. — Miss R., set. 13 years, only daughter of Lineas Wood, Esq., of Xew Bedford, Mass., was placed under my care for the treatment of J'ott's disease of the spine, May 31, 1856. 6 The disease commenced in October, 1855, with severe pain in the right hip, extending down the thigh, and occurring in parox- ysm. This took place more frequently at night, often depriving the patient of rest, followed with loss of appetite, emaciation, general debility, and great contraction of the right lower extremity. These symptoms continued up to the time my attention was first called to the patient, eight months from the commencement of the disease, when the case presented a prominent, angular cur- vature of the spine backward, inclining somewhat to the left, shortening the right leg three inches, the result of caries of the two upper lumbar and lower dorsal vertebras. The patient was of a nervous temperament, strumous habit, and lax fibre, with a weak and frail constitution. Treatment.—This consisted in the application of a spinal appa- ratus upon the new principle, constructed to meet the exigencies of the case, and readjusted as circumstances required, the use of cod liver oil, three times a day, a generous diet, and daily exercise upon the feet, what the patient was able to bear without fatigue,. On the adjustment of the apparatus, the relief from pain, as in the former case, was immediate and complete, and did not recur. The patient improved rapidly, until the last of September fol- lowing, when there were manifest indications of an abscess, form- ing in the right lumbar region near the curvature, which retarded somewhat the process of recovery, The abscess was opened the last of December, and discharged three pints of pus, mixed with a proportion of dark colored blood. The discharge continued abundant for several weeks, and at a subsequent period, numerous pieces of bone, varying from one (piarter to half an inch in length, passed with the discharge of matter. October ], 185*1.—The abscess is now healed, the curvature completely reduced, the lower extremities of equal length, origin- al form fully restored, and the patient, whose weight at the time I first saw her (sixteen months since) was only sixty-five pounds, has now attained to one hundred and fourteen pounds, and, in all respects, has a healthy and robust appearance. Boston, Oct. 1, 1857. [ Report of Cases to be continued. ] 7 LETTER FROM DR. BARTLETT. New Bedford, Nov. 10, 1851 Dr. J. A. Wood, Boston, Dear Sir :—I have just read, in the proof of the forthcoming num- ber of the N. Y Journal of Medicine, your report of two cases of Pott's Disease of the Spine. The cases are correctly reported, but more facts of interest connected with them might have been given. The case of the Irish girl, on 6th street, at Mrs. Dunbar's, which you have not reported, is quite as remarkable in all respects as either of the above. Your treatment of her case was commenced early in 1855'. She has been perfectly well for more than a year. I can not urge upon you too strongly the importance of taking outline drawings of all cases where much deformity exists. They would have been equally as striking in the last two as in the first of the above cases, if they had been taken. The other cases treated by you in New Bedford, although not less successful or important than the above outlines, are of less consequence, because less deformity existed. Very respectfully yours, Lyman Bartlett. SPINAL COMPLAINTS. A new method of treating Curvatures of the Spine and Spinal Weakness. BY DR. J. A. WOOD. Office, 215 Washington Street—Residence, Marlboro' Hotel, Boston. Having examined the Skrpentine Spring Apparatus used by Dr. J. A. Wood in the treatment of Curvatures of the Spine, we recommend it as efficient and comfortable to the patient. Henry J. Bigelow, M.D., Prof, of Surgery, Harvard University. Geo. Hayward, M.D., Ex-Prof, of Surgery, Harvard University. Winslow Lewis, M.D. J. V. 0. Smith, M.D., Mayor of Boston. Samuel W. Thayer, Jr., M.D., Prof, of Anatomy in the University of Yt. John W. Warren, M.D. Willard Parker, M.D., Prof, of Surgery of New York, may also be refer- red to as to the utility and results of this mode of treatment. B®* Dr. Wood is at the Everett House, New York, on the 1st and 3rd Saturdays and Mondays of each month, where he may be consulted. » .