When the disease is high up in the dorsal region, or in the cervical region, an additional arrangement is necessary for the support of the head. It consists of a light piece of iron fixed by the bandage to the back, and projecting up wards as high as the head. From the top of it a piece of iron arches directly over the head, and from this arch straps are suspended for support ing the head by the chin and occipital bone behind.
When the bandage is being put on, a pad ought to be placed over the stomach, to be removed after the plaster has "set" over it. It leaves room for the distension of the stomach with food. Even the presence of an abscess on the back need not interfere with this method of treatment. For, after the plaster has hard ened, an opening or window can be cut in the jacket at a marked point exactly over an ab scess, allowing of its being regularly dressed.
Besides this mechanical treatment there is the constitutional—good nourishment in plenty, fresh air, cod-liver oil, Parrish's chemical food, or other syrup of the phosphates of iron and lime, and other tonics.
Any abscesses that may appear in the course of the disease require to be opened, to let the matter escape, and treated in the ordinary way. (Refer to ABSCESS. See INDEX.) The practice of waking and keeping up issues, by the use of caustics, at the side of the backbone, is not now so frequently followed as formerly.
Lateral Curvature (Seoliosis).---This is not a disease, like the former one, attended with serious destruction of tissues. It is due to a relaxed state of the body, to greater develop ment of muscles on one side than on the other, or to weakening of one side, which some special employment might give rise to; or it is due to the adoption of a peculiar attitude, such as "standing at ease" on the right leg with the left knee a little bent, or to an attitude assumed in writing or at needlework, specially if the person be short-sighted. Nurses who carry
children always on the same arm are liable to it. It is sometimes the result of chest disease, pleurisy, or of one leg being shorter than the other. It attacks girls between the ages of ten and fifteen, particularly those who grow too fast for their strength.
Signs.—On uncovering the whole back the curve of the backbone is observed to follow the outline of the italic f; one shoulder is higher than another, and one shoulder-blade projects. The right shoulder is usually the high one, and the left is depressed. Similarly, while one hip, usually the left, projects, the other is curved inwards (Fig. 32). There may be other symp toms, due to the deformity causing oppression of breathing, or pressure on the nerves pro ducing pains.
The treatment is not dissimilar to that of the former disease. Mechanical support by the plaster-of Paris • bandage may be used, the unnatural atti tudes being, as far as possible, discarded. But special benefit will be derived strengthen ing food, from the use of medi cines already ad vised for pos terior curvature, and from the patient being caused to take regular exercise, and to have a moderate course of gymnastic exercise. If a tripod, &c., such as used for the plaster bandage, is available, the patient should swing herself from it for about five or ten minutes every morning, just lifting herself from the ground. Cold bathing, particularly cold sea-water bathing, is of great use. The patient should not sleep on a feather-bed but on a firm mattress, and should rise early.