Tubercular Disease of the Spine. 529 



The specimen shows loss of substance of the fourth, and 

 part of the fifth vertebrae, and some disease of the second. 



The destruction of the bodies has left the spinal canal 

 completely exposed from the front. G. C. 725. 



Presented by Ah-EX. Watson, F.R.C.S.E. 



7. 243. Tubercular Disease, with g-reat Destruction of the 



Bodies. — Left half of a spinal column, pelvis, and part of skull 

 — partially cleaned and dried, illustrating the above. 



Margaret M'N., about thirty, was known by the inspector of poor 

 for about ten years as a prostitute of the very lowest type. Some defor- 

 mity was supposed to have been present since childhood, and she had 

 gone about " doubled-up " certainly for ten years before death. She went 

 into the workhouse in an exhausted condition, and died there from increase 

 of the exhaustion, without symptom of any definite disease, probably 

 the result of a debauched life and ill health. She was able, however, 

 to "move about" until a month or two before her death. There had 

 been a sinus discharging for some time, beside the projecting spines. 

 On each side a chronic abscess was found extending about half-way tO' 

 the groin, and filled with caseous material, becoming calcareous. 



The bodies of the vertebrae from the ninth dorsal to 

 the second lumbar inclusive, as well as portions of those of the 

 seventh and eighth dorsal and third lumbar, have disappeared. 

 The corresponding spinous processes have been fused into a single 

 piece, which has been accidentally broken after death. The 

 dorsal spine above the disease has been curved forwards, i.e. 

 with the convexity towards the thorax, and in consequence the 

 ribs from the fourth to the tenth have been curved markedly 

 upwards and forced together. There is considerable calcareous 

 debris now in some parts of the canal, but this must have been 

 loose during life, and probably has not pressed against the nerves. 

 The narrowing of the outlet of the pelvis, and the tilting back 

 of the promontory of the sacrum, are characteristic of Kyphosis. 



The absence of paraplegia is remarkable, and is probably 

 to be explained by the gradual escape of the debris through the 

 sinus and the slow formation of the curves. G. C. 3244. 



Presented by Josh SON Symington, F.R.C.S.E., 1891. 

 2l 



