After some time, as the state of the patient’s health improves, the
bones in some degree regain their original firmness, and the curvatures
are rendered permanent. New bone is deposited in the concavity of the
curve, at first in irregular masses, but afterwards becoming condensed,
and assuming a more regular form, the column is thereby supported and
strengthened.
Bending of the spine backward, with depression of the spinous
processes, is extremely rare. But curvature forward, with projection of
these processes, is by no means uncommon, and is generally supposed to
be caused by caries of the bodies of the vertebræ; in many instances,
however, it arises from interstitial absorption only.
Curvature from caries of the vertebræ, though not so frequent as the
curvature from other causes, is met with pretty often. In adults, the
curvature from ulcerative absorption is more common than that from
softening of the bones. It is attended with the formation of purulent
matter, which presents in the loins, at the top of the thigh, or near
the anus; the bones may become affected secondarily, though much
less frequently, in consequence of the formation and accumulation of
purulent matter in their neighbourhood. There is pain in the loins; the
patient walks in a stooping posture, and often complains of pain in
the knee or thigh. The lower limbs sometimes become paralytic, as also
the sphincters and extremities of the hollow viscera; this, however,
may arise, without curvature, from softening of, or effusion on, the
chord, or diseased thickening of its membranes. In some cases the
palsy supervenes slowly; at first the patient has an awkward gait; he
lifts his feet high to avoid stumbling, and afterwards puts them down
clumsily and suddenly; the foot, in some cases, is extended, so that
the patient is unable to plant the sole on the ground. Retention of
urine occurs, and is followed by incontinence, with copious deposits.
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