Tubercular Disease of the Spine. 517 



,to the fourth lumbar vertebra, partly dissected — in spirit, 

 illustrating the above. 



The man died after the opening of a psoas-abscess. One was 

 present on either side. 



Between the seventh and eighth dorsal vertebrae there has 

 been some absorption and sinking together of the bodies. 

 Between the eleventh and twelfth there is a fibrous-looking 

 nodule. Between the first and second lumbar vertebrae there 

 is an area of caseation softening and absorption, and a similar 

 but smaller area between the second and third lumbar 

 •vertebrse. 



An abscess is shown on the right side, with its walls laid 

 open. It was found on dissection to communicate by narrow 

 passages with the caseating centres in the lumbar vertebrae. 



This specimen teaches the following important points : — 

 t(l) That centres of caseation may exist, and give rise to 

 abscesses, without any displacement of the vertebrae ; (2) that 

 the communication between such centres and an abscess cavity 

 -or cavities may be very small and tortuous, and inaccessible 

 from any wound that could be made during life ; (3) that 

 there may be separate centres of tuberculosis in the spinal 

 column, causing displacement at one place and an abscess at 

 another, and that the different centres need not in any way 

 communicate ; and (4) that the different centres may be in 

 different phases of advance or subsidence. G. C. 3189. 



Presented by i . Shaw M'Laren, F.R.C.S.E., 1890. 



7. 223. Tubercular Deposits in Several Vertebrae.— Part 



of the eleventh and twelfth dorsal and first four lumbar 

 vertebrae — macerated, to show the effects of tubercular disease 

 in several places. 



The upper part of the eleventh dorsal vertebra has been 

 absorbed. Upon the twelfth dorsal vertebra, what seems 

 to be a healed cavity is seen at the front, with new bone 

 formation on either side. The first lumbar vertebra shows one 

 or two partially healed apertures in front, with advancing 



