BENEFICIAL RESULTS 
KKOM TUK USB or 
MECHANICAL APPLIANCES 
IN 
POTT’S DISEASE OF THE SPINE, 
Illustrated. with. Cases. 
BY 
JACOB A. WOOD, M. 1)., 
OF N?\sr YORK. s'! 
From the New York Journal of Medicine and The American MedkaPTimes. 
Neto Yorfe: 
STEAM PRINTING HOUSE, CORNER OF CENTRE AND WHITE STREETS. 
1874. BENEFICIAL RESULTS 
FROM THE USE OF 
MECHANICAL APPLIANCES 
IN 
POTT’S DISEASE OF THE SPINE, 
Illustrated, with. Cases. 
BY 
JACOB A. WOOD, M.D., 
OF NEW YORK. 
From the New York Journal of Medicine and The American Medical Times. 
tfeto Yotft: 
STEAM PRINTING IIOUSE, CORNER OF CENTRE AND WHITE STS. SPINAL DISEASES. 
A NEW AND EFFICIENT METHOD OF TREATING CURVATURES OF 
THE SPINE AND SPINAL WEAKNESS, 
B Y 
JACOB A. WOOD, M.D., 
No. 31 Cooper Institute, New York. 
Having examined the Serpentine 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., Professor of Surgery, Harvard University. 
George Hayward, M.D., Ex-Professor of Surgery, Harvard University. 
Winslow Lewis, M.D., Boston, Mass. 
J. Y. C. Smith, M.D., Boston, Mass. 
John W. Warren, M.D., Boston, Mass. 
Willard Parker, M.D., Professor of Surgery, College of Physicians and Sur- 
geons, New York. 
John T. Metcalfe, M.D., Professor of Institutes and Practice of Medicine, 
University of New York. 
Stephen Smith, M.D., Professor of the Principles of Surgery in the Bellevue 
Hospital Medical College. 
George Marvin, M.D., Brooklyn, N. Y. 
H. I. Bowditch, M.D., Boston, Mass., Professor of Clinical Medicine. 
Samuel W. Thayer, Jr., M.D., Professor of Anatomy in the University of Vt. 
James H. Crombie, M.D., Derry, N. H. 
REFERENCE. 
It is not expected, nor even desired, that Physicians who refer their 
patients to me should give up the management of their cases, except so far as 
relates to the mechanical part of the treatment. POTT’S DISEASE; 
OR, 
ANGULAR CURVATURE OF THE SPINE. 
Having devoted my time and attention to the treatment of 
spinal diseases for the last six years or more, examining closely 
the results that have followed, I now propose to show, by the 
report of cases, that a cure in Pott’s Disease of the Spine does 
not, in all cases, “ necessarily consist of curvature,” as is usually 
maintained ; but that the further progress of the curvature may 
generally be arrested from the time treatment is commenced, 
and, in cases of a recent character, a cure effected with the 
curvature nearly or quite reduced by appropriate mechanical 
appliances, and the internal use of medicinal agents, to the en- 
tire exclusion of setons, issues, or any other counter irritant, or 
even the recumbent position. 
Case 1. 
Master , aged 9 years, son of Dr. Lyman Bartlett, of New 
Bedford, Mass., was placed under my care for the treatment 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 oast—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 com- 
plain occasionally of pain in the left hip. 
In January, 1855, had an attack of croup, followed with se- 
vere paroxysms of cough, which continued about three weeks, 
when an attack of measles supervened, of extreme severity. 6 
For three months following the attack of croup, little or no 
respiratory murmur was pei*ceptible 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 D(octor 
himself, 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 .vertebrae, pro- 
ducing a bold, angular projection of the spine backwards, a pend- 
ing .and prominent abdomen, with a flattened chest. The lower 
extremities 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 
<vas 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 apparatus 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 7 
were of equal length, and could be fully straightened without the 
least difficulty. 
The patient quickly 
recovered, has grown 
rapidly, and has since 
full y 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- 
panying outlines of 
the case were taken 
by the Doctor at his 
own suggestion, a 
gentleman 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 
i\\c 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 promi- 
nent, with a full and capacious chest. It should he here observ- 
ed, that the curvature, since the last outline was taken, has 
gradually diminished, till every appearance of it has become 
extinct. 
Case 2. 
Miss R., set. 13 years, only daughter of Lineas Wood, Esq., of 
New Bedford, Mass., was placed under my care for the treatment 
of Pott’s Disease of the Spine, May 31, 1856. 8 
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 ex- 
tremity. 
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 
curvature 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 vertebrae. 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 apparatus 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 such daily exercise upon 
the feet as 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 December 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 
quarter to half an inch in length, passed with the discharge of 
matter. 
October 1, 1857.—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. 9 
LETTER FROM DR. BARTLETT. 
New Bedford, Nov. 10, 1857. 
Dr, J, A. Wood, Boston. 
Dear Sir :—I have just read, in the proof of the forthcoming 
number 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 Sixth 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 cannot 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. 
Case 3. 
Son of Mr. , West Roxbury, Mass., aged 2 years 
and 1 month, of light complexion and scrofulous diathesis, came 
under treatment for Pott’s Disease of the Spine, June 15, 1855. 
The deformity in this case consisted both of a lateral and an- 
gular projection of the spine, each well defined and strongly 
marked, as seen in fig. 1. 
The former consisted of a bold reflection of the spine to the left, 
extending from the cervix to the sacrum, and the latter of an an- 
gular projection of the eight, ninth, and tenth dorsal vertebrae. 
To avoid tedious detail, I give only a few of the leading facts 
in the history of this case, as related by the mother. 
She informed me that the child had always evinced a peculiar 
weakness of the back from its birth, a few months after which 
an irregularity in the course of the spine was discovered. 
There was a tardy development of strength, and a manifest 
want of the ordinary physical force and energy in the child up to 10 
the age of 16 months, when it was suddenly attacked with appa- 
rent paralysis, and remained perfectly helpless for many weeks, 
with slight, occasional febrile excitement, extreme paleness, and 
ultimate emaciation. 
The recovery from this attack was protracted and imperfect, 
during which the deformity continued with a more rapid increase 
than at any previous period of the disease, and, overpowered by 
all the contingencies in the case, the child had never been able to 
walk, up to the commencement of the treatment. 
The body was thrown into such a position, by this distortion of 
the spine, that the abdominal viscera were pressed with great 
force into the left iliac region, presenting there the appearance of 
a large tumor, as seen at (a) in the above cut. 
The early history of this case, and its subsequent developments, 
suggest the following inquiry. Is Pott’s Disease of the Spine ever 
congenital ? 
The treatment applied in this case, was simply mechanical 
spring-like in its action, and comfortable to the patient, a gener 
ous diet and exercise in the open air. 
Four days from the first application of the apparatus, the patient 
walked across the room, and four weeks from that time, he walked 
a third of a mile without any apparent fatigue. 
By keeping the apparatus well adjusted, and supporting prop- 
erly every part embraced by it, the general health and strength 11 
improved rapidly, the deformity gradually diminished until nearly 
removed, when the process was somewhat interrupted by inatten- 
tion of those having charge of the child to the instructions given. 
Consequently, there yet remains a very slight lateral variation of 
the spine, from a normal position, yet susceptible of removal, not 
exhibited in fig. 2, as the objects of these reports is to illustrate 
more particularly, the result of treatment in angular curvature 
of the spine. 
With this exception, fig. 2 illustrates correctly the result of 
treatment in the case. 
The patient has grown rapidly, and for more than two years 
has been vigorous, robust, fat, and healthy. 
Case 4. 
Son of Mr. , Chicago, 111., aged 8 years, of 
light complexion, strumous habit, pale, emaciated, and sickly in 
appearance, weight 36 lbs. (precisely what it was four years pre- 
vious), came under treatment for Pott’s Disease of the Spine, 
March 3, 1857. 
The disease had existed more than three years, and involved 
the 5th, 6th, and 7th dorsal vertebr®, producing at that point a 
formidable posterior projection of the spinal column, with its con- 
sequent results to the contour of the whole system, as seen in 
fig. 3. 
Anchylosis seemed nearly, or quite complete, and no encourage- 
ment was given as to the result of treatment, beyond an improve- 
ment of the general health, and, perhaps, to some slight degree, 12 
the general form and figure of the patient, as circumstances would 
seem to forbid the accomplishment of more than that. 
The improvement in the form of the patient, as the result of 
treatment, is shown in fig. 4, which tnay be contrasted with the 
one above to illustrate it more fully, both of which were drawn 
with care and accuracy. 
The improvement of the general health and strength was still 
greater ; as, when first received, the patient was able to walk a 
few rods only, without being obliged to rest; but, at the expira- 
tion of two months, he had become strong, robust, and healthy, 
exercising vigorously upon his feet through the day, without any 
apparent fatigue. 
Fig. 4. 
The parents were then permitted to take the patient home. In 
May, after the lapse of one year, he returned again greatly im- 13 
proved, but not as much as he might have been had more particu- 
lar attention been given to his case during the last six months, 
as the apparatus had not been kept properly adjusted, being some 
what out of repair. 
This case is reported more particularly to show the advantage 
of well-adjusted, appropriate, mechanical support to patients em- 
barrassed and overpowered by the burden of position often enforced 
upon them by the destruction of some portion of the spinal column. 
The treatment consisted in the adjustment and readjustment of 
an apparatus, briefly described in a former number of the N. Y. 
Journal of Medicine, galvanism, free diet, and what exercise the 
patient could bear. 
Case 5. 
The history of the following case was furnished by Dr. Lyman 
Bartlett, of New Bedford, Mass., who attended the patient through 
the fever to which allusion is made, the patient still continuing 
under his charge up to the time I first saw her. 
Miss Elizabeth Potter, aged 16, bluish-gray eyes, light florid 
complexion, dark brown hair, of scrofulous and consumptive 
family, was attacked with typhoid fever about September 12, 1857 
The fever became of unusual severity, insomuch that, from the 
30th September to the 3rd October, her life was despaired of. 
She began, and continued slowly to convalesce from about the 
20th October. From the 1st to the 9th December, she was able 
to sit up in a chair for several hours daily. 
About the 6th December, she began to complain of pain in the 
back on sitting up. On the 10th December, after sitting up 
longer than usual, she was attacked with severe pain in the 
region of the first lumbar vertebras. This continued for two or 
three weeks with such severity, that she could not be turned in 
bed ; and was only relieved by presence of the hand, constantly 
applied day and night for the period of nearly a week. 
On examination (made with great difficulty on account of the 
pain caused by moving her), a curvature of the spine was discov- 
ered, of the length of about four vertebrae, having its centre 
between the last dorsal and first lumbar vertebrae, and to the 
degree represented in fig. 5, as nearly as could be judged ; her 
condition rendering an exact outline drawing impracticable. 
She had severe bed-sores over both trochanters, then of some 14 
six weeks’ standing, and which were not entirely healed until 
the February following. 
Her emaciation was extreme, greater than ever before wit- 
nessed by the writer in any case, from any cause. 
On raising her out of the hollow in the bed into which she had 
settled, and making extension and counter-extension from the 
ankles and head, the curvation was somewhat reduced and the 
pain in the spine diminished. This partial relief was continued 
by the firm application of a broad swathe around the loins. 
Her condition did not materially improve, however, until after 
the 12th January, 1858, at which time Dr. J. A. Wood applied 
his apparatus for disease of the spine. 
Her great emaciation rendered it difficult to fit 
the apparatus, so as not to give her annoyance, 
for several days. So scraggy was she, that it 
seemed like an attempt to fit stays to a gun- 
lock. By means of much padding, however, Dr. 
Wood succeeded, and, in the course of three 
or four days, relief was complete whilst the 
apparatus was applied ; but pain returned'for 
several months afterwards whenever the ap- 
paratus was removed. 
Now (July 24,1858), she has been able to sit 
three or four hours a day for several weeks 
past without suffering, and can turn in bed as 
well as ever she could. 
Her flesh and strength are now very fair, 
and steadily improving. She may be consid- 
ered nearly cured. 
In the appended cut, A represents the char- 
acter and degree of deformity, as described by 
Dr. Bartlett, that existed previous to an attempt 
at its reduction and relief of the patient. B represents the posi- 
tion of the spinal column at the point of curvature, eight months 
after the commencement of the treatment, the general health and 
strength of the patient at the same time rapidly improving. 
Case 6. 
Son of Mr. Charles T. Stevens, No. 8 New Prince Street, Boston, 
Mass., aged 5 years, of light, rather florid complexion and scrofu- 
Fig. 5. 15 
lous diathesis, was placed under my charge for treatment of 
Pott’s Disease of the Spine, March 30, 1857. 
The case then presented an angular curvature of the spine, 
projecting, posteriorly, nearly one and a quarter inch, involving 
the three lower, and having for its centre the eleventh dorsal 
vertebrae. The body inclined considerably to one side, and the 
left hip was elevated one and a half inch above the right. 
Respiration was hurried and laborious, and partial paralysis of 
one leg, with other impediments, rendered locomotion somewhat 
difficult. 
From the mother I obtained the following history of the case, 
from its commencement to the time that it was placed under my 
care': 
In March, 1854, at the age of two years, the patient was 
attacked with lung fever; whooping-cough supervening, the sick- 
ness was protracted and severe, characterized with great prostra- 
tion, copious sweating, and ultimately extreme emaciation. 
In the Autumn succeeding the attack, the cough still contin- 
uing from the first, hoemorrhage from the lungs ensued, of which 
there were several attacks, and at one time, in the space of 
twenty-four hours, there were, by estimation, from three to four 
ounces of blood thrown up in the act of coughing ; the patient 
becoming more prostrate and pallid, little or no hopes were enter- 
tained of his recovery. 
In April, 1855, at the expiration of one year from the com- 
mencement of this sickness, the patient had, however, nearly 
recovered, when he was attacked with severe pain in the bowels 
and partial paralysis of the lower extremities accompanying ; he 
was deprived of the power of locomotion, which did not return 
again in any degree until the expiration of eight or ten months. 
Difficult respiration and a tumid state of the abdomen then exist- 
ed to a marked degree. In the Spring of 1856, a small knuckle 
was discovered projecting from that portion of the spinal column 
already referred to, which continued to increase, with a recur- 
rence of the pain in the bowels, at intervals, with all the general 
symptoms, more or less aggravated, that usually attend such 
cases. 
March 30, 1857.—The progress of the disease has continued 
unabated up to the present time, and resisted a/1 attempts to 
arrest it by mechanical or other means employed for that purpose, 16 
which, as remarked by the mother, were I'esorted to soon after 
the trouble was first discovered 
My treatment of this case was entirely mechanical, accompanied 
with such instructions in reference to the general health of the 
patient, as should usually be observed in a normal or healthy 
state of the system. 
An apparatus was constructed to meet all the indications in 
the case as well as possible, by giving that support to the spinal 
column which would, in the most efficient manner, relieve the 
affected part from all undue pressure from tfie weight of the 
supei’ior portion of the body, as well as to prevent the evil con- 
sequences of the various motions of the body at that point. 
The apparatus was adjusted and readjusted as often as the cir- 
cumstances in the case required, with a direct bearing upon the 
transverse processes of the projecting vertebrae. 
By this arrangement, the bowels are elevated and retained in 
their proper position by gentle support, thus relieving the supe- 
rior portion of the body from a dragging weight that serves not 
only to enhance the original trouble, but greatly to embarrass 
respiration. 
Convalescence commenced at once, and continued without 
interruption. 
The curvature is completely reduced, the patient has grown 
well, and is now straight, robust, and healthy. 
Case 7. 
Mrs. K., of Woburn, Massachusetts, aged thirty-six years, tall 
in stature, of fair complexion, and of somewhat scrofulous dia- 
thesis, came under treatment for Pott’s Disease of the Spine, 
July, 1858. 
The following is a brief history of the case from its commence- 
ment to the time I first saw it, as related by the patient. 
Eight years ago she was attacked with pulmonary disease, un- 
provoked by a cold, characterized at first with a dry, hacking 
cough, which, at a subsequent period, became urgent, attended 
with copious expectoration, occasionally tinged with blood, emaci- 
ation, and extreme prostration, with hectic and night sweats. 
This sickness continued a little more than six months, and for 
many weeks during that period, the attending physician and 
friends of the patient entertained little or no hope of her ulti- 
mate recovery 17 
While in this situation, she first began to experience pain in the 
vicinity of the second and third lumbar vetebrae, with some de- 
gree of tenderness on pressure, which did not subside on her 
recovery from this severe sickness, but both continued with 
greater or less severity at times, soon accompanied with curva- 
ture of the spine, which was quite apparent, even when the patient 
was standing or walking about. 
In April, 1851, the case assumed a more formidable character. 
At that time, from some violent exertion on the part of the 
patient, in consequence of sudden fright, the pain was greatly 
increased and the curvature more rapidly developed than at any 
former period of the disease. 
The difficulty pro- 
gressed, and on exam- 
ining the case in July, 
1858, when my atten- 
tion was first directed 
to it, I found the sec- 
ond and third lumbar 
vertebrae projecting 
posteriorly, as seen at 
B, in the accompanying 
cut, about half an inch, 
forcing those directly 
above and below, more 
or less, from their nor- 
mal position. 
In connection with 
this posterior projec- 
tion, there was, also, a 
lateral reflection of the 
spinal column, to the 
left, embracing the 
lumbar, and several of 
the lower dorsal ver- 
tebrae, as seen at A, in 
the accompanying fig- 
ure, which represents, 
correctly, the extent and degree of this lateral inclination of the 
spinal column. 18 
The pain was severe in the back, hip, and left lower extremi- 
ty, with a partial loss of power in that limb. The muscles were 
contracted, drawing the body to one side, rendering exercise 
difficult and painful. 
The treatment was simply mechanical, and consisted in the 
application of a Spinal Apparatus, snch as has been described 
in a former number of the New York Journal of Medicine, ap- 
propriately adjusted and readjusted at such times And manner 
as the nature of the case demanded. 
The usual instructions in regard to regimen in those cases 
were given, with the recommendation only of moderate exercise. 
The patient has fully recovered, with a complete, redaction of 
the curvature, as seen at C in the preceding cut. 
June 16, 1859. 
Case 8. 
Son of Mr. G , city of New York, aged six years and two 
months, of light complexion, scrofulous diathesis, and full de- 
velopment, came under treatment for Pott’s Disease of the Spine. 
Feb. 20, 1860. From the mother 
the following history of the case 
was obtained :—In April, 1859, tho 
child was attacked with whooping- 
cough of unusual severity, which 
continued several weeks. In June, 
the cough still continuing, the pa- 
tient was seized suddenly with pain 
in the back, and for several days 
was unable to rise from the recum- 
bent position without assistance. 
Shortly after, an attack of dysen- 
tery supervened, which continued 
three or four weeks, reducing the 
child to a degree which rendered j 
its recovery doubtful. 
In September, after apparently 
recovering his usual health and 
strength, an injury was produced 
by a slight fall. The pain in the back continued and became 
quite severe at times, more particularly in the night. In Octo- 
tty 1. 
Fig. 2. 19 
ber, a slight projection was discovered in the lower part of the 
spine. In December, the projection had greatly increased, the 
pain was more constant and severe ; one limb was considerably 
contracted and drawn up, and locomotion much embarrassed. 
Since that time the child’s condition had been growing worse. 
Upon examining the case there was observed a bold posterior 
curvature, as represented in Fig. 1, and quite acute in its form, 
having for its centre the third lumbar vertebra. Locomotion 
was performed with difficulty, and while standing or sitting the 
patient was constantly inclined to rest upon his hands for sup- 
port, and for relief from pain and suffering. 
The treatment consisted in mechanical pressure upon the affect- 
ed part, and general support applied to the body (flexible in its 
character), to render the support to the spinal column as efficient 
as possible ; together with the use of some of the more ordinary 
tonics usually given in such cases. The mechanical appliances 
were often readjusted, and such alterations in their construction 
were effected, from time to time, as the changes in the size 
and form of the curvature and figure of the patient rendered 
necessary. 
Upon the application of the apparatus, the patient was relieved 
of his suffering and enabled to walk about comfortably. The pa- 
tient was soon allowed to exercise freely in the open air, being 
restricted only to two hours’ rest during the day to avoid too 
much fatigue. 
The patient is now strong, robust, and healthy, with the curva- 
ture reduced as seen in Fig. 2. It is worthy of note that, as in 
the present, very many cases of Pott’s Disease of the Spine are 
developed under the influence of whooping-cough, measles, or 
scarlatina. 
The outline of this case was taken five or six months since, at 
which time the curvature was still gradually diminishing. 
Case 9. 
The son of Mr. K , of New York, aged six years and nine 
months ; complexion fair, but not denoting a decidedly scrofulous 
diathesis, first came under treatment for Pott’s Disease of the 
Spine, December 6, 1860. 
In July, 1859, the child had a slight fall, and was seized at 
once with severe pain in the back, extending down the right leg. 
He became nearly or quite helpless, and remained so for about 20 
three weeks. At the expiration / that time exercise upon the 
feet was attempted, but performed with great difficulty and pain 
About three months after that the child began to lean to one 
side, and to support himself, while walking or standing, by rest- 
ing his hands upon his thighs, or upon a chair, lounge, or other 
object within his reach. The right leg was drawn up, and loco- 
motion was performed with the heel raised from the floor. As 
the difficulty advanced, this abnormal position became more ap- 
parent, locomotion more difficult, the pain more severe, both dur- 
ing the day and through the night, and in the paroxysms the 
child was powerless. 
Upon examination I observed a posterior projection of the third 
lumbar vertebras, with the second forced somewhat from its nor- 
mal position. The amount of deformity in this case was not so 
great as usually occurs in a much shorter space of time after the 
commencement of the disease. The suffering of the patient, how- 
ever, as represented by the mother, was far greater than I have 
been in the habit of seeing. 
Treatment consisted in the application and use of mechanical 
appliances, similar to those already presented to the reader, to- 
gether with some of the preparations of iron, as a tonic, and the 
extract of conium to relieve the pain ; also, a generous diet 
and what exercise the patient was able to endure in the open 
air. Upon the application of the apparatus the relief from pain 
was very great, but not so complete as in the majority of cases 
to which it has been applied. About two months after the 
treatment commenced, and while the patient was doing well, 
he met with an accident in falling, which rendered him again 
nearly helpless. For about twelve days after the accident, the 
suffering was so intense whenever the support to the spinal col- 
umn was, in any degree, diminished, that the apparatus was not 
removed during that time. Whenever its removal was proposed, 
the little fellow would tremble and scream in anticipation of the 
suffering that would follow. I may remark, in passing, that 
three other cases of a similar character have occurred in my 
practice. Whether standing, sitting, or lying down, neither of 
the cases could dispense with the apparatus for a single moment 
without the most intense pain. In one it was not removed for 
the space of two weeks, in another for seven weeks, and in the 
third, that of a young physician in Massachusetts, it was worn 
for several successive weeks (the precise number I can not now 21 
recall), without being removed for a change of under-clothing or 
any other purpose whatever, as in all the others referred to. I 
allude to these circumstances more particular- 
ly to show the importance of evenly adjusted 
and well adapted mechanical support in Pott’s 
“Disease of the Spine, for the purpose not only 
}f making the patient comfortable while suffer- 
ing from the disease, but of bringing the case 
to the most favorable, as well as speedy term- 
ination. 
To return to the case under consideration. 
About five months subsequent to this, while 
the patient was improving well and able to 
play about, he received a blow from a stick in 
the hands of another child, directly upon the 
diseased bone, whereupon he fell instantly to 
the floor. A good deal of pain and difficulty 
in moving about followed, and, subsequently, 
a superficial abscess formed at that point. 
Since recovering from its effects, the patient 
has improved and done well up to the present time. He has suf- 
fered but little or no pain for the last eight months, and is now 
vigorous, robust, and healthy, with the curvature reduced as 
seen in the accompanying cut. 
The degree of deformity that now exists, and here represented 
is only about one third what it was when my attention was first 
called to the case, and it is still gradually diminishing. 
The son of Dr. , of Madison Co., New York, aged six years 
and five months, of scrofulous diathesis, first came under treat- 
ment for Pott’s Disease of the Spine, December 13, 1859. 
The following is an abridged history of the case as communi- 
cated by the father: 
When about three years and a half old, while complaining 
somewhat of his back from a previous injury, the child fell from 
a low stool to the floor, injuring the spine so as to render him 
unable to walk for two days. Upon examination there was ob- 
served a slight posterior projection of the sixth dorsal vertebra. 
Treatment was at once commenced with blisters and issues near 
the affected part, internal use of iodide of iron and cod liver oil, 
Case 10. 22 
together with special attention to the diet. No means hate been 
left untried, from the commencement of the disease, that would 
seem to afford the least prospect of relief, but ail, apparently, to 
little or no purpose. The disease steadily progressed, attacking 
one vertebra after another, until two or three above and below 
the original point of the disease became more or less involved. 
The deformity continued to increase, and locomotion was per- 
formed only with great difficulty by resting oue hand upon the 
thigh. In this manner he attempted to move about, but could 
only walk a short distance without lying down or leaning upon 
some object for the purposes of rest and support. He at this time 
was subject to frequent and severe paroxysms of pain in the low- 
er extremities, with partial loss of muscular power. 
Upon examining this case, I found the patient much emaciated, 
feeble, and presenting a bold and extensive posterior projection, 
as represented in Fig. 1. 
The treatment consisted in the use of mechanical means, the 
immediate effect of which was 
complete relief from pain and 
suffering, a more erect position 
of the patient, and enabling him 
to walk without resting his hand 
upon his thigh. During the first 
three months of the treatment 
there was an improvement of 
the general health, strength, and 
figure of the patient, but with 
little reduction of the curvature. 
At tlie expiration of that time, 
however, the curvature began to 
lessen more perceptibly, and has 
gradually decreased until its size 
is very much reduced, as seen in 
Fig. 2, which is a correct outline 
drawing of the case, taken nearly 
six months since. For nearly two 
years the patient has been healthy and robust, and is extremely 
active. 
As in this, so in a large majority of cases of long standing, 
with a great loss of bony substance, improvement is much more 
rapid after the case has been under treatment several months. 
Pig. 1. 
Fin. 2. 23 
The object of the foregoing reports, which were published, 
only, at the suggestion and earnest request of members of the 
medical profession, who had witnessed the results of the treatment 
of some of those cases, was to illustrate, as first proposed, the 
beneficial effects of mechanical aid in the treatment of angular 
curvature of the spine and to demonstrate the practicability of its 
reduction in many instances, notwithstanding the general assump- 
tion that a cure in Pott’s disease of the spine must necessarily 
consist of curvature. 
The first case of the sei’ies here recorded, had there been no 
other adduced in support of the proposition, is ample proof of the 
fallacy of such assumption. 
That was a case of most decisive character, unfavorable both 
in its aspects and in its antecedents, as will be seen by a perusal 
of its history. 
The few reported were well attested cases, as the facts there 
related and outline drawings will show. 
Other cases, illustrative in their character, might then have 
been added to the number, as well as, very many that have since 
come under treatment, equally well attested and in all respects 
as important and striking in their results, might also but have 
not been reported. 
It was far from my intentions, not wishing to abandon the 
general practice of medicine, in which I was then engaged in a 
somewhat distant city, for a specialty, to report those or any 
other cases that came under my care, with that object in view, 
whatever the results of treatment might be, and was induced to 
do so, only by an expressed desire of others in the profession who, 
as they remarked, had been watching the opening of a new era 
in the history and treatment of Pott’s disease, with deep interest. 
Up to the. time those reports were first published there was, l 
believe, nowhere to be found on record a single case of complete 
reduction of angular curvature, of a marked and decided character, 
from caries of the vertebrae by any method of treatment, whatever. 
Although an almost infinite variety of mechanism, constructed 
for that purpose, as well as, for the general benefit of the patient 
had been used since long before the cause and character of the 
deformity was but imperfectly understood ; yet, it had proved 
not only unsuccessful but, often, a source of painful suffering and 
great discomfort to the patient while wearing it. 24 
That fact has created some prejudice in the minds of those, 
both, in and out of the profession, against all mechanical assist- 
ance, whatever, in those cases. 
But, I have never witnessed in the treatment of any class of 
diseases happier results, nor, more prompt and complete relief 
from extreme suffering by whatever means employed, than I have 
often seen follow the application of well devised and properly 
adjusted mechanical support in diseases of the spine. 
Reference here to a single case, perhaps, may serve to elucidate 
and confirm this statement. 
A boy about seven years of age with angular curvature be- 
tween the shoulders, had been under treatment nearly a year and 
a half and wearing, by the suggestion of the attending physician, 
such mechanical support as he thought best adapted to the con- 
dition and comfort of his patient. 
The case from the first was characterized with frequent and 
severe paroxysms of pain with much constant, local suffering in 
the carious region. The pain continued unabated and the curva- 
ture quite prominent and increasing in size, as represented to me 
in the history given of the case when my attention was first 
called to it. 
On the application of such support to the spinal column as has 
been here alluded to in connection with these reports, the pain 
was, at once, relieved and the patient freed from suffering. 
But whenever an attempt was made to remove the corset for 
readjustment, or, slacken the pressure in the least or, oven, a 
suggestion to that effect, so great was the fear and dread of the 
recurrence of the pain and suffering so long endured that the 
terror stricken patient would become, at once, so agitated and 
alarmed that he could, by no means, be persuaded to submit to its 
removal, which was never for one instant effected, until the ex- 
piration of seven weeks from the time of its first application. It 
required a long time after that, unusual care and caution in 
adjusting and readjusting the corset to prevent a return of the 
pain. 
The patient has, now, so completely recovered his health and 
strength, with an erect and good form, as to require little or no 
further use of mechanical aid. 
Such has been the general result of my experience for the past 
eighteen years in the treatment of those cases characterized with 25 
much suffering1 and, whether the pain exists in a greater or less 
degree, the patient is usually relieved from it and remains com- 
fortable during the progress of recovery from what is generally 
considered one of the most distressing and fatal class of diseases- 
That should be a matter of surprise to no one who understands 
the anatomical structure of the spine, that the more perfectly the 
affected part is relieved of superincumbent pressure, as well as 
motion at the point of disease, the less the patient will suffer, and 
the more rapid and certain will be his recovery. 
Can mechanical aid in the treatment of a fractured limb be 
more essential to the comfort of the patient and a successful 
issue in the case, than to a weakened and literally broken back ? 
One is a solution of continuity of a sound and healthy part by 
sudden force and violence ; the other by diseased action of slow 
and painful development, in which, cause and effect alike demand 
prompt, energetic, and the most judicious use of remedies. 
From the notes and observations of Sir James Earl, F. R. S., 
Surgeon Extraordinary to the King, we quote the following: 
11 We apply splints to a broken leg while ossification is forming; 
we do not allow any pressure to be made upon it while that nat- 
ural process is going on ; and the patient afterwards takes off 
the weight of the body from it by means of crutches until it is 
perfectly strong, and capable of its own duty. I am at a loss to 
find any good reason or sound argument why the same means of 
assistance, at least so far as lies in our power, should not be ap- 
plied in cases of a weakened spine, in order to take off superin- 
cumbent pressure, and to endeavor to restore the actual form of 
the spine during the progress of the cure ; if this be not attempt- 
ed, or cannot be brought about at this time, the consequence must 
be that, the back will remain crooked during the cure to which 
I will add, and ever after. He goes on further to say : “The 
period when we are most likely* to improve the form of the pillar 
must be during the progress of the cure, while the parts allow of 
some latitude of motion ; when they are once become consoli- 
dated and fixed by the growth of bony matter, no alteration 
scarcely can take place but what is effected by the future general 
growth of the whole body.” 
Here, we have the views of a cotemporary of Mr. Pott upon 
this subject, whose opinion, from his extended knowledge and 
experience, as well as rank, (Surgeon to his Royal Highness,) 26 
is entitled to the fullest confidence. And what can bo more sug- 
gestive of the necessity of well adjusted support to the spine in 
a weakened and diseased condition, unless it is the prompt and com 
plete relief it brings when applied, than to see a child thus affected 
constantly seeking relief by resting with the elbows on what- 
ever object happens within its reach ; or, supporting itself with 
the hands upon its thighs when standing or exercising upon tho 
feet. The patient’s own natural instincts thus point to the legiti- 
mate, direct, and most practical source of relief from his painful 
and suffering condition. Not until a short time previous to the 
death of Mr. Percival Pott, which occurred December 22d, 1788, 
at the age of seventy-five years, was there but little known of the 
nature of the disease we are now considering. 
He was a man of eminence in the profession he so highly hon- 
ored, and, for forty-two years, Surgeon of St. Bartholomew’s 
Hospital, London. To him is the credit due for the first correct 
and complete description of its pathological character in a treat- 
ise on the subject, the last of his literary productions, entitled 
“ On the Palsy of the Lower Limbs.” 
It is more particularly for the purpose of answering tho oft re- 
peated inquiry, “ Why is this called Pott’s disease ?” that this 
special reference is made. 
It was merely an incidental circumstance that led to his dis- 
covery of the true character of the disease, and to the introduc- 
tion of that mode of treating it which consisted in the employ- 
ment of issues in the immediate vicinity of the caries, by the use 
of the seton, moxa or caustic, and confining the patient to the 
horizontal position during the greater part of the time that he 
was under treatment, as he could not bear the erect position. 
From the time of Mr. Pott’s discovery as far back, at least, as 
to the days of Hippocrates, the curvature was considered acci- 
dental, and this abnormal position of the spine was supposed to 
be the result of some injury to the back, as by a blow, pulling, 
lifting, carrying or drawing some heavy load, and forcing one or 
more of the vertebrae from their normal position, independent of 
any morbid or diseased action whatever of the parts involved. 
When paralysis of the lower limbs occurred, it was considered 
merely a nervous affection and treated as such, until the appear- 
ance of the excurvation, to which, was then assigned the cause 
of this loss of power in the lower extremities. But an abscess 27 
near the curvature, incidentally occurring in one of Mr. Pott’s 
patients, in which the paralyzed extremities were restored to 
their normal condition in a somewhat shorter space of time than 
usual in such cases, first led to the belief that the whole trouble 
was the result of disease and weakness at that point. That 
belief was confirmed and the fact fully established on fur- 
ther investigation of the subject by post-mortem examination, 
which revealed the existence of erosive inflammatory action, 
caries, and disintegration of the vertebrae involved in the dis- 
placement. 
For this pathological discovery the credit has been universally 
conceded to Mr. Pott. 
It is, however, to be regretted that his mode of treating the 
disease did not more fully and satisfactorily meet the wants and 
necessities of that class of patients. 
It consisted, as has already been stated, in the use of issues 
in some form in the immediate vicinity of the disease, and placing 
the patient in a recumbent position in bed or upon a lounge ; thus 
depriving him of the advantages of out door air and exercise, 
which are of most vital importance in preserving the tone and 
general strength of the system under the exhaustive influence of 
the disease. 
Of the patients thus treated, very many die of prostration from 
long confinement and extreme suffering, and of those that recover, 
a large proportion are seriously deformed and crippled for life. (From the New York Medical Journal.) 
REMARKS ON THE EARLY SYMPTOMS AND TREATMENT 
OF 
POTT’S DISEASE OF THE SPINE. 
J. A. Wood, M. D., New York. 
Within a limited period, since the report of the preceding cases| 
over four hundred and seventy others were treated in like manner 
and with similar results. 
About eighteen per cent, of the number treated were affected 
with paralysis of the lower extremities, and nearly twenty per 
cent, with abscess, both occurring at an earlier or later stage 
of the disease, which is met with at all periods of life, from 
early infancy to old age. 
The oldest person, however, that has come under my observa- 
tion, affected with this disease, was aged fifty-five years. An- 
other, in reference to whose case I was consulted by letter, was 
sixty years of age, and formerly president of one of our Western 
colleges, and was discharging the duties of that office when at- 
tacked with the disease. A more recent case, in a person fifty 
years of age, is now under treatment. 
It occurs more frequently, however, in children under ten years 
old ; but from two to five years of age may be considered the 
period of its most frequent occurrence. 
The disease was often preceded by scarlet fever, whooping- 
cough, or measles ; and children who have suffered from a severe 
attack of the former are very liable to fall into a state of perma- 
nently impaired health, and become a prey to some of the various 
chronic forms of scrofula, among the more serious of which is 
caries of the vertebrm. 
Measles, also, in children and young persons of a scrofulous 29 
diathesis, frequently awaken the slumbering germs of that fear- 
ful malady, Pott's disease ; while whooping-cough acts only me- 
chanically upon the system in developing more rapidly the dis- 
ease already existing, but not detected, perhaps, by any of its 
characteristic symptoms when the cough commenced. In a few 
instances the disease succeeded severe and protracted typhoid 
fever ; first manifesting itself when the system, from its reduced 
condition, was comparatively disarmed of all power of resistance 
to the development of any hereditary or constitutional taint that 
might exist, as is frequently the case with incipient phthisis. 
From the commencement of the disease up to that period when 
the curvature first made its appearance (usually in the form of a 
small knuckle), the average length of time did not vary much 
from ten months, and was often characterized by paroxysms of 
most acute suffering. 
When paralysis of the lower extremities occurred, the recovery 
of the patient from his paralytic condition, under the treatment, 
was only a question of time, and that, often, of brief duration. 
When long protracted, it was more generally the result of im- 
prudence and sometimes obstinacy of the patient, in persisting 
in too much exercise upon the feet when first commencing to walk. 
In one instance, the patient, of a restive habit, had nearly re- 
covered from the second attack when he fell from a considerable 
height and became the third time paralyzed, from which he has 
not regained, and probably never will regain, the use of his limbs. 
Paralysis did not, I think, exist in one instance where the dis- 
ease was situated below the last dorsal vertebra ; but it occurred 
in an increased ratio proceeding upward from that point. Neither 
was there a single case of it in the upper extremities connected 
with genuine Pott’s disease. Such cases are very rarely found 
on record. It did occur, however, in one or both arms in the case 
of the patient sixty years old already alluded to, as having caries 
in the cervical region, throwing the head forward and downward 
with the chin resting upon the sternum. This deformity was at- 
tended with severe and incessant pain, over which opiates, as I 
was informed by the attending physician, although liberally ad- 
ministered, appeared to have little or no control. 
The treatment in those cases, in addition to the mechanical 
support, consisted of dry friction applied to the back and limbs, 
with flannel, or the bare hand, and the use, sometimes, of the gal- 30 
vanic battery. The loss of the power of locomotion, as a contin- 
gent of this disease, may be viewed as comparatively of minor 
importance. The patient is very sure to regain the use of his 
limbs under treatment. With a restive disposition the paralysis 
sometimes proves an advantage, as too much exercise upon the 
feet interferes with the efforts to reduce the curvature, and ren- 
ders the ultimate success of the treatment less certain. 
Dr. Pott ascribed his success in the treatment of paralysis of 
the lower extremities in this disease to the use of issues applied 
near the affected portion of the spine, and recommended their 
continuance for several months after the patient had recovered 
from his paralytic condition. It may be well to consider whether 
the remedy here recommended possesses merit superior to every 
other in such cases. Of this there appears to be no direct proof; 
and if the fact can not be clearly substantiated by practical re- 
sults, such practice should be discarded and treated as a source 
of unnecessary pain and suffering to the patient. 
Abscesses sometimes created but little constitutional disturb- 
ance ; neither did they in many instances appear to affect mate- 
rially the ultimate results of the treatment, as ten or twelve only 
of the whole number thus affected terminated fatally, and those 
were generally of a most decidedly strumous character. In some 
instances the abscess terminated by absorption. This was more 
frequently the case when their locality was such as to subject 
them to the pressure of the corset. That result is very desirable 
whenever possible to effect it in any way, as it saves the patient 
from much discomfort, and, at least, temporary physical prostra- 
tion and the attendants from an unpleasant and protracted duty, 
as the discharge seldom ceases until consolidation of the affected 
portion of the spine is far advanced. A premature use of the 
lancet, when abscess is the result of caries of the spine, is more 
frequently attended with serious constitutional results than when 
its contents are permitted to escape by a spontaneous opening. 
If an abscess is quite painful it may be better, perhaps, to give 
early exit to the pus, even at a greater risk of constitutional irri- 
tation ; and, if the surrounding tissues are likely to become too 
deeply involved by the further expansion of its walls, as is some- 
times the case, the use of the lancet is imperative. Otherwise, it 
is better, usually, that the abscess should remain unmolested 
until its contents have approached near to the surface. 31 
Very many of the cases presented for special treatment were 
of long standing, with marked deformity, impaired health, and 
general prostration, some having been subjected to one form of 
treatment and some to another. The seton, moxa, and various 
other forms of counter-irritation, had been resorted to, while in 
many cases the recumbent position was strictly enforced, in some 
instances, for a period of nine, twelve, and fifteen months, the 
patient not being permitted to rise from this position, even when 
taking nourishment. 
But these different methods of treatment have all failed to ac- 
complish what has often been effected, unattended with pain and 
suffering to the patient, by appropriate mechanical appliances in 
connection with a liberally sustaining diet and the use of such me- 
dicinal agents as the cases appeared to demand, while the patient 
was comparatively unrestrained from air and exercise during the 
treatment. 
In the early stages there is a manifest necessity for mechan- 
ical support in the treatment of the disease, indicated by the 
patient’s instinctive and frequent inclination to seek it in lean- 
ing, or throwing himself upon whatever may chance to come 
within his reach, that will afford such support. And the more 
perfect the support in its design and adaptation, used in the 
treatment of this disease, the sooner it is applied, the more skill- 
fully it is adjusted and readjusted to the patient, the more satis- 
factory will be the ultimate results of the treatment. 
The early symptoms of caries of the spine are sometimes 
very obscure, and it is often difficult, more especially for those 
not familiar with its characteristic features, to form a correct 
and satisfactory diagnosis. A physician may, and many even 
those of high standing in the profession do, pass through a series 
of years of professional service without ever having a single case 
of the kind come under their observation ; and as there are other 
diseases with symptoms somewhat analogous to this in its early 
stages, it is often confounded with them, and treatment instituted 
upon a false theory and pursued until an excurvation of the spine 
settles beyond all controversy the character of the disease. 
During this protracted period of fruitless effort to arrest the 
further progress of a disease, the pathological character of which 
may not, perhaps, for a moment have been suspected until it has 
passed into a chronic form, we lose the most favorable opportu 32 
nity of effecting speedy relief and complete restoration of the 
patient without deformity. 
The disease sometimes comes on insidiously ; but in a large 
majority of cases the attack is sudden and severe, the pains oc- 
curring spasmodically, and are provoked by mental as well as 
physical causes, such as fright, mirth, or violent passion. The 
pain is usually quite remote from the scat of disease, and may 
be experienced anywhere in the course of the nerves leading 
from it, or at their extremities. Consequently, it may be in the 
side, chest, stomach, bowels, or hips and lower limbs, just ac- 
cording to the locality of the disease. That is one reason why 
those not familiar with its symptoms are so liable to be misled, 
and to confound it with other affections more commonly met with 
in those regions where the pain exists. The disease is, there- 
fore, often mistaken for neuralgia of the chest, stomach, bowels, 
lumbago, nephritis, rheumatism, and various other affections ; 
and it was stated in the history given of one case that came un- 
der my care, that the child had been treated two years for worms, 
the treatment continuing some time after the discovery of the 
curvature, so firm was the belief that worms were the prime and 
only cause of its illness. A patient will be frequently seized with 
a paroxysm while playing about the house, when it will throw 
itself suddenly upon the floor and refuse to be taken up or han- 
dled while the pain continues. When the pain has ceased, the 
patient will rise and return again to its amusements, as though 
nothing special had occurred. 
The introduction to a sad sequel frequently occurs in the night. 
A child, which but a few hours before was put into bed, appa- 
rently in perfect health, wakes suddenly out of sleep in wild agi- 
tation, shrieking and crying vociferously. The family is aroused, 
and the cause of this sudden alarm carefully sought for, and not 
infrequently the solution is found in that very popular theory, 
“an attack of worms;” or, perhaps, a frightful dream. But, in 
doubt as to which is the real cause, there is administered, both 
some favorite nostrum as a vermifuge, and a liberal amount of 
solace. Eventually the pain subsides, the child drops to sleep, 
and the ever-watchful and anxious mother, full of faith in the in- 
fallibility of the remedy, retires again to rest, with the delusive 
hope that the relief is final and complete. But this is often only 
the commencement of a series of similar attacks which follow at 33 
various intervals, by day as well as night, and result in protracted 
sickness and extreme suffering, from which the patient sometimes 
finds relief only in death. These paroxysms of pain are peculiarly 
liable to occur whenever the subject first wakes out of sleep ; 
especially so, unless moved and handled with the utmost care 
and caution, which is not always the case when intrusted entirely 
to the care of servants and nurses. 
Cases occasionally occur in which there is, from the first, but 
little or no pain experienced, the position of the patient when 
standing, sitting, or walking, furnishing perhaps the only tangi- 
ble evidence of the existence of the disease, and is sometimes so 
marked and peculiar, as to render the character of the disease 
unmistakable. 
The position and habits of the patient are often such as to 
attract early attention. He inclines to stoop or lean to one side, 
and sometimes does both, instinctively thrusting his hands into 
his pockets, or resting them upon the thighs to give support to 
the back. He avails himself of whatever object of support may 
chance to be within his reach upon which to lean, and relieve the 
affected part from the superincumbent weight of the body. The 
position is modified somewhat, according to the locality of the 
disease. When situated in the lumbar region it is, usually, more 
erect than natural—the shoulders are elevated, and the head 
thrown backward. If the disease is situated in the cervical re- 
gion, there is a constant inclination to support the head with the 
hand placed under the chin, or to throw it backward or to one 
side, resting it upon the shoulder. 
Locomotion, from weakness of the back, is usually performed 
in a shuffling manner ; and not unfrequcntly does a child, pre- 
vious to the development of other symptoms, manifest a tendency 
to trip and fall, for which he is often reprimanded before the 
cause is understood. A complete loss of power of the lower ex- 
tremities generally in those cases succeeds this tendency sooner 
or late., and locomotion for a longer or shorter period is suspended. 
Pain and tenderness, upon pressure over the affected region, 
are very seldom experienced by the patient; but tapping on it, 
or jarring the spine in any way, is commonly attended with more 
or less suffering, and a sponge wet in hot or cold water, arjd ap- 
plied to it, usually produces pain. Any disagreeable impression 
imparted suddenly to the back, causing a violent contraction of 34 
the spinal muscles, has a similar effect. Placing the patient upon 
his stomach across a narrow bench or stool, is one of the various 
methods that may assist, in addition to those above mentioned, 
in forming a correct diagnosis where doubt in a case exists. In 
this und various other positions of the body the patient will usu- 
ally evince more or less suffering, even before any degree of 
excurvation of the spine is detected. 
Whenever that makes its appearance, all question of doubt 
and uncertainty as to the nature of the difficulty is at once set- 
tled. But before that occurs, however, there necessarily exists 
considerable disintegration both of the osseous and libro-cartila- 
genous tissues implicated in the disease. 
It has already been stated that the length of time that ordina- 
rily intervenes between the onset of the disease and first appear- 
ance of any abnormal projection of the spinous processes, (usually 
in the form of a small knuckle), did not vary much from ten months. 
During that, as well as at a subsequent period, an opportunity 
sometimes occurs in consequence of the supervention of some 
acute difficulty, fatal to the patient, of examining the condition of 
the various tissues involved in caries of the spine, and observing 
its progress from the incipient to its more advanced stages. 
The appearances vary somewhat, however, in different cases, 
and the progress of the disease is not always uniform. But some 
idea, both of its pathological character and progress of develop- 
ment, may be obtained by a view of the following engraved illus- 
trations of the disease in sotne of its more or less advanced stages, 
both before and after the curvature has become visible. 
Figures 1, 2, and 3 represent merely the vertebral column in 
its normal state—a front and lateral view—together with a verti- 
cal section showing the cellulated structure of the vertebras and 
also that of the spinal processes, which are more compact and 
solid in their composition, and consequently much less subject 
to caries. 
Sometimes nearly the entire vertebral substance disappears, 
while the processes that were attached arc found to have under- 
gone but little change from the ravages of the disease. 
These, with the arches, often constitute the main portion of the 
angular projection, and are pressed together by the superincum- 
bent weight of the body in such a manner as to give its surface 
an irregular and “scraggy” appearance. 35 36 
, Figure 4.—Case of five and a lialf months standing, in which 
the attack was sudden and intensely severe, occurring while the 
child was quietly sleeping in bed and without any premonition, 
there having been up to that time no 
manifest indications, whatever, of the 
existence of the disease. 
At first the paroxysms of pain oc- 
curred only in the night, while through 
the day there was no apparent suffering. 
But at a later period the pain occurred 
often during the day, in similar form and 
severity. 
The position of the child, when stand- 
ing or in motion, soon attracted attention and lfcd to the suspicion 
that the hip was the seat of difficulty, and the attending physi- 
cian mistook the disease for that of the hip joint. Patient, set 2 
years and 4 months ; cause of death, scarletina. 
Post-mortem examination revealed congestive, inflammatory ac- 
tion in the upper third of the eighth dorsal vertebra, which was 
slightly carious, as here represented, as was also the lower por- 
tion of the Seventh. 
Figured—Case in which death occurred about ten months 
after the first attack of pain denoting the character of the disease. 
From a history of the case up to the time I first saw the pa- 
tient (about two months previous to its 
death), it was evident there had existed 
nothing unusual in the character and de- 
gree of pain and suffering experienced, 
from what generally occurs in this disease. 
Age, 4 years and 3 months • cause of 
death, disease of the brain. 
An autopsy disclosed caries of the up- 
per portion of the seventh dorsal vertebra, 
with slight erosion of the lower portion 
of the one above, with ulceration of the 
intervertebral substance, as seen in the cut. 
Figure 6.—A case of neai-ly nine months’ continuation, when 
death occurred, and of a decidedly strumous diathesis, in which 
the pain did not occur so much in the form of paroxysms as in 
many others, but less severe and more constant. There was a 
F,<r. 4. 
Fig. 5. 37 
good deal of constitutional derangement and general prostration 
of the system and emaciation, with hectic flush upon the cheeks 
when the case first came to me, a few 
weeks only previous to the death of 
the patient. Age, five years and two 
months ; cause of death, measles. 
An autopsy disclosed necrosis of the 
eighth dorsal vertebra, with deep ero- 
sions in some portions of it. The seventh 
had become somewhat involved, the low- 
er margin of which was eroded, and the 
intervertebral substance softened and 
more or less wasted. 
Disintegration had not proceeded to that extent, however, as 
to change the normal position of the spine outwardly at that 
point. 
A considerable amount of pus was found in the immediate 
vicinity of the diseased bone, and the surrounding tissues in a 
disordered condition. 
The progress of the disease was evidently more rapid in this 
than in most cases, and a slight projec- 
tion of one or more of the spinous pro- 
cesses, marking the progress of the 
disease, would soon have become ap- 
parent had the patient lived. 
Figure 7.—Nearly eighteen months 
had transpired in this case between 
the attack of the disease and death of 
the patient. 
The history of the case, when my at- 
tention was first called to it, revealed 
nothing essentially different from what 
is usually contained in the sad rehear- 
sal of the pain and suffering so common 
with this class of patients. 
The attack was preceded by scarlet 
fever of a mild type. Age, 3 years and 
10 months ; cause of death, pleuro-pneu- 
monia. 
A post-mortem disclosed caries of the fifth dorsal vertebra, the 
Fig. 6. 
Fig. 7. 38 
lower third of which had nearly disappeared ; the upper portion 
of the sixth hud become carious, and the intervening cartilege 
disorganized and wasted. 
The ninth dorsal had also become affected, giving evidence of 
the existence of congestive, inflammatory action, with slight ero- 
sions in the upper portion of that vertebra. The disease but 
rarely exists in remote portions of the spine, simultaneously, in 
the same subject. 
Figure 8.—Twenty-two months subsequent to fho onset of the 
disease, we here find nearly one half of 
the seventh dorsal vertebra removed by 
caries, with erosive ulceration in the low- 
er portion of the sixth. 
From the history of the case, that of a 
child aged four years and seven months, 
there was manifestly less suffering expe- 
rienced by the patient in the early stage 
of the disease than usual. But at the ex- 
piration of four months the pain became 
intensely severe at times, and the general characteristics of the 
disease more decidedly marked and progressive up to the time I 
first saw it, about six weeks 
before the death of the patient, 
the result of an accident. 
Figure 9.—This morbid 
specimen most clearly and dis- 
tinctly illustrates the progress 
of the disease and its effects 
upon the bony substance in- 
volved in a single instance at 
the expiration of nearly four 
years from the first attack of 
the disease. 
As here observed, the third 
lumbar vertebra is almost en- 
tirely removed by caries and 
attrition, the second and fourth 
in close proximity for lack of intervening substance, and both 
deeply eroded, carious, and disintegrated to a considerable ex- 
Fig. 8. 
Fig. 9. 39 
tent. The posterior portion of the fifth also evinces some evi- 
dence of the ravages of the disease. 
The history of the case, (that of a lad aged about eleven years), 
as related to me when I first saw it, about a year previous to the 
death of the patient, would apply to very many of this class as 
to the general character of the symptoms throughout the different 
stages of the disease up to the time I first commenced treating 
the case. 
With the corset on and properly adjusted, the patient exercised 
freely and apparently with 
as little suffering and in- 
convenience as though in 
good health ; and it was 
while engaged in a severe, 
sportive contest with one 
of his playmates that he 
received the injur}’ which 
ultimately resulted in his 
death. 
Could these patients al- 
ways be kept under proper 
restraint and from undue 
exercise during the treat- 
ment, it would greatly fa- 
cilitate the progress of 
their recovery, render it 
more certain, and the re- 
sults, often more complete 
and satisfactory. 
But, with the whole abdominal viscera so thoroughly supported 
from their most depending portion by an elevating power, and the 
spinal column so firmly braced and well protected against motion 
or jarring sensation at the seat of disease, the patient usually 
experiences such complete immunity from all suffering, and feels 
that “ security against injurious and painful motion,” even, while 
vigorously exercising, as sometimes to induce him to exceed all 
proper limits in that respect, as in the latter case, which termi- 
nated fatally by the supervention of an acute disease of one of 
the vital organs. 
Figure 10.—This is a vertical section of the morbid specimen 
Fig. 10. 40 
last described, the counterpart of which was taken to the College 
of Physicians and Surgeons, New York, for preservation. 
It shows simply the interior condition of the vertebrae involved 
in the disease. 
There have not only been opportunities of witnessing the 
( fleets of tliis disease, at some of its different stages, upon the 
various tissues involved, but also to observe the results of the 
efforts of Nature in supplying the waste and repairing the injury 
when properly assisted by mechanical aid. 
“Nature,” it is said, “abhors a vacuum.” And it may bo 
further stated that she manifests this abhorrence in a no less 
degree, often, when caused by caries of the vertebrae than under 
other circumstances, by the thorough manner in which she fills 
the space with material substance, as illus- 
trated in one of the succeeding cuts. 
The accompanying figure (11), represents 
the case of a young lady set. 15 years, placed 
under my care by her attending physician, 
then or about that time, President of the Mas- 
sachusetts Medical Society, who guarded the 
honor of the profession with as much zeal and 
criticism, perhaps, as any other member of it. 
With the history of the case, he presented 
mo an outline drawing of it, as here repre- 
sented, taken by himself, at his own sugges- 
tion ; and any one examining the case would, 
at once, have been prctty#thoroughly convinced 
that these outlines were no exaggeration of 
tlie facts, as to the amount of deformity that 
existed. 
At that time the patient was prostrate and 
helpless, and could not be turned in bed with- 
out acute suffering, frequently attended with 
spasms She had .been in that condition for 
several months, when mechanical means were first applied, which 
gave her almost immediate relief from suffering. 
The progress of recovery at first was not rapid ; at the expira- 
tion of five or six weeks was much more so, and continued on 
until her recovery was complete, without leaving a trace of the 
curvature visible. About three years subsequent to her rocov- 
Fig.U. 41 
ery, from this disease, and all treatment in reference to it had 
ceased, this patient died of consumption, hereditary in the 
family. 
On an examination of the spine, there was found a solid mass 
of bone, somewhat rough and irregular in its outlines, filling the 
space originally occupied by a large portion of the last dorsal 
vertebras, and smaller portion of the one immediately above and 
below, as illustrated in figure 12. 
It may be proper, perhaps, to state that the patient, from a 
protracted and painful illness, had become so reduced in flesh 
and strength before I saw the case (her emaciation exceeding 
anything I ever before witnessed), that she, of necessity, re- 
mained in bed nearly the whole time during the first three or 
four months she was under my care, which 
undoubtedly facilitated somewhat the reduc- 
tion of the curvature and process of consol- 
idation, rendering the latter more complete. 
The curvature, however, from the time 
it was discovered to that when the first 
attempt was made to arrest and reduce it 
by mechanical pressure, was rapidly in- 
creasing, notwithstanding the patient all 
the time was confined to the recumbent 
position, with the exception of a brief pe- 
riod each day, for the space of about two 
weeks. 
Two other cases might be added to fur- 
ther illustrate the process of Nature in restoring portions of 
the vertebrae removed by caries ; but, as they were situated 
in the cervical region, where the waste of bony substance 
was very much less than in the case already described, it would 
not promote the ends of medical science, except by multiplying 
cases, which would here seem to be of but little practical im- 
portance. 
In this connection, to further illustrate the decided and benefi- 
cial effects of the mechanical support here alluded to, I will 
refer to a case of caries of the spine of long standing, that came 
under my care about seven months since. 
December 13, 18*12, the son of Mr. John Bauer, of College Point, 
L. I., aged 14 years, came into my office, assisted by two attend- 
Fig. 12. 42 
ants, each supporting him by the arm, and thus sustaining in a 
great measure the weight of the body. 
He was suffering acute pain, which was rendered more intense 
in attempting to stand or walk. 
The disease, as I was informed, had then existed six years and 
• a half, resulting in a large waste of bony sub- 
stance, with an angular projection near the 
junction of the dorsal and lumbar portions of 
the spine, as seen in the accompanying cut. 
On account of previous engagements, I was 
unable to give this patient the regular and 
requisite attention at once. Consequently, to 
relieve the pain and render his condition com- 
fortable as possible for a few days, a substi- 
tute for something more complete was em- 
ployed until I was at liberty to meet the de- 
mands of the case more fully. 
Upon its application and adjustment the 
patient walked freely about the room, with- 
out aid or assistance, affirming that he was 
free from pain and suffering. 
After the lapse of eight or ten days, a more 
perfect appliance was adjusted to the patient, 
and the usual attention received, when his 
general health and strength began to im- 
prove rapidly. 
With the exception of about six weeks in 
the early part of the treatment, the young lad 
has been steadily employed at some light work, 
receiving, all the while, such compensation for 
his services as would be deemed just and ample reward to those 
of his years of full strength and vigor, and the curvature, at the 
same time, gradually diminishing. 
The patient is still improving in general health and strength, 
as well as in figure ; and there is no reason to doubt that the use 
of the same means would have been attended with equally deci- 
sive and satisfactory results at any previous period of the disease, 
and the patent saved from the extreme suffering to which he had 
been subjected throughout its various stages to the time treat- 
ment commenced. 
Fig. 13. APPENDIX. 
In the November No. (1873), of the N. Y. Journal of Medicine, 
the editor refers to “ a paper read before the Medical Society of 
the State of New York in 1863, and published in its Transactions 
on the mechanical treatment of disease of the bodies of the spi- 
nal vertebrae,” and states that “ the author has written a preface 
to its German edition in which he gives a summary of his present 
views upon the chief pathological points which bear upon the 
question of a mechanical treatment, and believes that Pott’s dis- 
ease has a traumatic origin, that it is essentially inflammatory in 
in its early stages, and that it is curable.” ' 
The reader has only to refer back to some of the first pages of 
this circular, or to a late number of the N. Y. Journal of Medicine 
in 1857, for proof incontestable that the disease is not only “cura- 
ble,” but “curable” in some cases, at least, with a complete reduc- 
tion of the curvature. 
These facts wei'e demonstrated beyond all question or contro- 
versy nearly eight years previous to the time specified of the 
reading of that paper, and four years, as there represented, ante- 
rior to the commencement of the treatment of those cases, upon 
which that document was based. 
The first case, that of the son of Dr. Lyman Bartlett, of New 
Bedford, Mass, (the outlines of which were taken by the Doctor 
and presented to me for publication), of the series here reported, 
now sixteen years since, remains a living illustration of these 
facts, as do others that follow in that connection, as well as a 
large number since treated but not reported, the results of “a 
mechanical treatment.” 
The case above referred to is the first instance of a cure with a 
complete reduction of angular projection of the spine from caries 
of the vertebrae, of a marked and decided character, found upon 
record. » 
At that period the concurrent testimony and influence of almost 44 
the entire medical profession, not only of this but of foreign 
countries, were arrayed against the use of mechanical means in 
the treatment of caries of the vertebra) and such results, as have 
often been clearly demonstrated by their application and use, it 
regarded as an utter impossibility, asserting that “a cure in Pott’s 
disease must necessarily consist of curvature.” 
Erichsen, with views in harmony with those here expressed 
upon this subject, in his popular work on Surgery published in 
1851, gives what he, in effect, declares to be the ultimatum in the 
treatment of this disease, and adds his testimony in reference to 
the results that follow : 
“ Rest in the horizontal position,” he says, “ is the ordy impor- 
tant element in the treatment. In fact the principles of treatment 
in these cases are extremely simple : the improvement of the gen- 
eral health by good diet, tonics, and sea air, and the employment 
of counter irritation suited to the age of the patient, is all that 
can be done.” He adds, “ Very commonly the disease terminates 
in abscess and death.” 
Abscess has existed in nearly twenty per cent, of the cases 
that 1 have witnessed ; in a vast majorit" of which, however, it 
occurred before I ever saw the patient. 
There is far less tendency to its formation in those cases where 
the spinal column is thoroughly supported and the affected por- 
tion of it well protected from jar and motion and as much at rest, 
as possible, at that point. And when abscess does occur, the pa- 
tients have a much fairer prospect of recovery with free access 
to the open air than when confined to the bed, or, shut up at 
home. 
Of the cases of Pott’s disease that have been unaer my care, 
less than eight per cent, of the whole number have proved fatal 
under the treatment. 
From the period of Mr. Pott’s discovery of the pathological 
character of the disease and his early treatment of it to the time 
specified, nearly three-fourths of a century, there had been no 
special advance towards a more successful and satisfactory 
method of treating this disease and bringing it to a more favora- 
ble issue. On the ninth page may be noticed the voluntary state- 
ment of Dr. Bartlett in reference to the results of the treatment 
in other cases then existing in New Bedford, and having witnessed 
in several instances results as striking in their character as those 45 
in that of his own son, he verbally declared it to be “the begin- 
ning of a new era in the history of the treatment of Pott’s disease.” 
Having spent several years in the hospitals of Paris and other 
foreign cities, with an extended professional experience, he had 
had, at least, a fair opportunity of becoming acquainted with the 
various methods, both at home and abroad, of treating this dis- 
ease and contrasting the results with those to which he here 
refers, as witnessed by him. 
It was from his knowledge of the facts thus obtained that this 
declaration was made. 
The seton, once of such frequent use in connection with the 
horizontal position in the treatment of caries of the spine, was 
regarded, then as now, by very many of the profession, as too 
painful in its application as well as unsatisfactory in its results, 
and totally abandoned. 
It was generally conceded that a large majority of cases thus 
treated terminated fatally, and that those, which did recover, 
were badly and permanently deformed. 
There was but little harmony in the views and practice of the 
medical profession in regard to any particular or well defined 
method of treatment and, consequently, many of those afflicted 
with the disease were left to drift wherever the current chanced to 
bear them. Not infrequently did they pass, sooner or later, into 
the hands of some mere mechanic whose illy contrived and grossly 
constructed appliance so enhanced the patient’s suffering as to 
bring all mechanical arrangements, for such purposes, into dis- 
repute. 
There were those, however, who seemed to regard the seton as 
the sine qua non in the treatment, judging from the emphatic 
declaration, May 15, 1860, of a distinguished member of the pro- 
fession of this city whose reputation, as a surgeon, was compara- 
tively “ world-wide.” 
While examining the case of a young man, son of Rev. , 
Conn., with a large angular projection of the spine between the 
shoulders, with paralysis of the lower extremities, both of which 
were powerless, he remarked : “ I know all about this disease, and 
any one who says he can do anything for it but put in a seton 
and place the patient in bed, is either a knave or a fool.” 
Nevertheless, the patient, who was then brought directly to 
my office without any knowledge, myself, of the statement here 46 
adverted to, until related to me many months after by the pa- 
tient’s father, to whom it was addressed, speedily recovered with 
the free and full use of his limbs and a very marked reduction of 
the curvature, without having to submit to either the one or the 
other. 
With the aid of the corset the patient was able soon to sit up, 
and his recovery was rapid under the treatment. 
In addition to what has already been shown in regard to the 
results of “ a mechanical treatment” of Pott’s disease of the 
spine, I will further illustrate by the report of cases of a pro- 
tracted and decidedly marked character, one of which came 
recently under my care. 
Case 1. 
The daughter of Mr. William Smith of Cavendish, Vt., seven- 
teen years of age, was brought to me November 19, 1873, (about 
five weeks since), for treatment of caries of the spine, in which 
were involved the two lower dorsal and the first lumbar verte- 
brae, resulting in a large waste of bony substance, with a corres- 
ponding posterior projection. 
The disease was preceded by whooping cough, at a subsequent 
period by diptheria, and was of nearly nine years standing. 
The general history of the case from its early development, as 
represented, did not vary essentially from others of that class, 
except in a peculiarly abnormal state of the general system in 
the early stages of the disease, rendering the final result of the 
case more uncertain. 
Up to the time I first saw the patient the treatment consisted 
in the use of mechanical support, (mi generic), blisters, caustic 
issues, and, for the larger portion of the time, the horizontal po- 
sition which was strictly enforced at one time for two years, with 
a strap around the hips, to which weights were attached and 
passed over the foot of the bed, the same arrangement around 
the chest under the arms with the weights suspended from the 
head of the bed, for the purpose of extension and counter exten- 
sion. 
When the patient came to me she could neither stand nor sit 
erect, and had not been able to walk a step for two years and 
nine months. 
As soon as the corset was applied, she took her mother by the 47 
arm ana walked around the room. The next day she did the 
same without help. 
At the expiration of eight days the patient was able to sit up 
all day, reading, writing, and entertaining her friends. 
Two weeks later, was able to walk, readily, up and down two 
long flight of stairs without assistance. 
Dec. 17.—A few days subsequent to this, the patient was out 
with her mother and friends “ shopping” and spending the day 
with them. 
Dec. 21.—Visited Central Park. 
Dec. 22.—Rode to Springfield, Mass., on her return home, arriv- 
ing at Cavendish in the afternoon of the following day, and, as I 
was informed, 14 with very little fatigue.” 
On the second day 
after her return home, 
Christmas, was out en- 
joying a sleigh ride in 
company with others, 
making a circuit of 
twelve miles. 
This was, simply, the 
result of “ a mechanical 
treatment,” and noth- 
ing more than Avhat is 
frequently accomplish- 
ed, by the same pro- 
cess. 
Figure 1 is an out- 
line representation of 
this case—A, pointing 
to the locality of the 
disease. 
In this position of the 
patient, the extent of, 
the angular projection 
is not brought fully into 
view. 
On the right side, above the hip, will be noticed a depression, 
or hollow, indicative of a slight curve of the spine to the left, a 
result of the disease. 48 
Case 2. 
Master George King of Paisley, Scotland, set. 13 years, came 
under treatment for Pott’s disease, September 23, 1869, 
When less than one year old the patient received an injury of 
the spine which resulted in caries of the second and third lum- 
bar vertebrae, so large a portion, of which, had been removed by 
disintegration and absorption of the osseous tissue that the ribs 
rested firmly upon the hips. 
By this adventitious support to the spine and whole super- 
structure, the affected portions were so relieved from pressure 
that the patient was quite free from acute suffering. 
A plaster cast was taken of the back at the commencement of 
the treatment, and at the expiration of nine months another. 
A wood cut from a photograph of each gives below a correct 
representation of their outlines, showing the change that occurred 
in the form and figure of the patient during that time. 
Fig. 1. 
Fig 2. 
The first figure, (A, pointing to locality of the disease), repre- 
sents the form of the patient at the commencement of the treat- 
ment—the body much depressed and lower ribs bearing heavily 
upon the hips. 
The second, as it was at the expiration of nine months, in 
which, the relative and more normal proportions of the chest, 
waist, and hips are represented. 
During that time the patient increased two inches and a quarter 
in height, with an increased expansion of the chest of one inch 49 
and a half in circumference, and returned to Scotland, strong, 
robust, and healthy. 
These results demonstrate, both, the supporting and elevating 
power of the mechanical means employed in the treatment of the 
case, without the aid of crutch or other support under the arms. 
Case 3. 
Son of Mr. J. Burnside, Valparaiso, Chili, South America, set. 6 
years, came to me July 22, 1872, with caries involving the seventh, 
eighth, and ninth dorsal vertebrae, which, after the elapse of nearly 
four years, had become very much disorganized and wasted, re- 
sulting in a huge angular projection of the spine at that point. 
The history of the case is as follows : When the patient was 
about two years and a half old, the nurse, while carrying him in 
her arms, fell with her whole weight upon the child, its back 
coming in contact with a sharp stone. 
From appearances, the contusion was quite severe, causing 
great pain at the time, and protracted suffering. 
Fcg. 1. 
Fiy. 2. 
About seven months after, a small knuckle was discovered, (a 
slight protrusion, probably, of the eighth dorsal vertebrae), which 50 
increased somewhat rapidly up to the time of the patient’s first 
visit. 
Both this and the preceding case were, most assuredly, of a 
“ traumatic originthe disease resulting from an injury of the 
spine, as it sometimes does. But, in a large proportion of cases 
it originates spontaneously. 
The head and shoulders were mucn depressed and pitched for- 
ward, while the natural form was sadly disfigured. 
The patient could take but little exercise when the treatment 
commenced, and, although but a short distance from my office, the 
nurse had frequently to carry him to and fro in her arms. 
He has had little or no pain during the attention—all the while 
steadily improving in general health, strength and figure—has 
increased three inches and a half in height in the past eighteen 
months, and is still improving and doing well. 
Figure 1, is a wood cut from a photograph of the case taken 
some little time after the commencement of the treatment, when 
the patient was unable to stand a sufficient length of time for the 
operation without leaning upon some object for support, as there 
noticed. 
In this position the locality of the disease is seen, to which A 
points ; but the extent of the curvature is not brought fully into 
view, it being in a considerable measure concealed by the pa- 
tient’s dress. 
At a subsequent period, the patient had improved so much in 
figure and acquired such a degree of strength as to be able to 
stand erect during the tedious process to which he was subjected, 
without having to depend, at all, upon any object of support upon 
which to rest, as seen in the succeeding figure. 51 
In the N. Y. Journal of Medicine, March, 1858, I gave a de- 
scription of the apparatus (designated Spinal Corset), with 
illustrations, used in the treatment, not only of Pott’s disease, 
but of lateral and other deformities of the spine and spinal weak- 
ness ; also of its application and modus operandi. 
It is so adapted to the patient as to inflict, necessarily, neither 
pain nor suffering, but is worn with ease and comfort, and suc- 
cessfully applied to infants less than twelve months old. The 
same facility attends putting on and taking it off as that of other 
corsets, and it is as entirely concealed from view when the patient 
is dressed. 
As these vary somewhat according to the character and condi- 
tion of the case, and other qualifying circumstances, they can not 
be fully defined until after an examination of the patient. 
Persons of limited means are always duly considered on a just 
representation of their pecuniary condition. 
On the application of the corset, the amount decided upon for 
a specified term of treatment,—three months, six months, or a 
longer period, is then received. 
At the expiration of that term new arrangements are made for 
further treatment of the case, and the stipulated sum payable at 
that time. 
Respectable board for patients from a distance, who are not 
otherwise provided for, can be obtained in good localities at a 
reasonable price. 
No corsets made and forwarded to order. 
Office consultation fee, from $5 to $10. 
Office hours from 9 A. M. to 1 P. M., and 2 to B P. M. 
J. A. WOOD, M. D. 
Office, No. 31 Cooper Institute, New York. 
Terms for Treatment.