As her right toe is turned outward rather more than natural, this shews the disease to be in the hip-joint; because, when the limb is stretched out, the toe cannot turn horizontally in the least without moving the end of the thigh-bone; although when the knee is bent, the toe can be turned through one third or half of a circle by the rotation of the tibia and fibula of the leg round each other. Hence if children are set in stocks with their heels touching each other as they sit, and are then made to rise up, till they stand erect, the socket or head of the thigh-bone becomes injured, especially in those children, whose bones are soft; and a shortness of that limb succeeds either by the bending of the neck of the thigh-bone, or by its getting out of the acetabulum; and a consequent rising of one shoulder, and a curvature of the spine is produced from so distant a cause.
M. M. An elastic cushion made of curled hair should be placed under the affected hip, whenever she sits; or should be fitted to the part by means of drawers, so that she cannot avoid sitting on it. A neck-swing, and lying down in the day, should be occasionally used to prevent or remove any curvature of the spine. The rest as in Species [13] and [15] of this genus.
[18]. Spina protuberans. Protuberant spine. One of the bones of the spine swells, and rises above the rest. This is not an uncommon disease, and belongs to the innutrition of the bones, as the bone must become soft before it swells; which softness is owing to defect of the secretion of phosphorated calcareous earth. The swelling of the bone compresses a part of the brain, called the spinal marrow, within the cavity of the back-bones; and in consequence the lower limbs become paralytic, attended sometimes with difficulty of emptying the bladder and rectum.
M. M. Issues put on each side of the prominent bone are of great effect, I suppose, by their stimulus; which excites into action more of the sensorial powers of irritation and sensation, and thus gives greater activity to the vascular system in their vicinity. The methods recommended in distortion of the spine are also to be attended to.
[19]. Spina bifida. Divided spine, called also Hydrorachitis, as well as the Hydrocephalus externus, are probably owing in part to a defect of ossification of the spine and cranium; and that the collection of fluid beneath them may originate from the general debility of the system; which affects both the secerning, and absorbent vessels.
A curious circumstance, which is affirmed to attend the spina bifida, is, that on compressing the tumor with the hand gently, the whole brain becomes affected, and the patient falls asleep. I suppose the same must happen on compressing the hydrocephalus externus? See Sect. XVIII. 20.
[20]. Ossis palati defectus. A defect of the bone of the palate, which frequently accompanies a division of the upper lip, occurs before nativity; and is owing to the deficient action of the secerning system, from whence the extremities are not completed. From a similar cause I have seen the point of the tongue deficient, and one joint of the two least fingers, and of the two least toes, in the same infant; who was otherwise a fine girl. See Sect. XXXIX. 4. 4.
The operation for the hare-lip is described by many surgical writers; but there is a person in London, who makes very ingenious artificial palates; which prevents that defect of speech, which attends this malformation. This factitious palate consists of a thin plate of silver of the shape and form of the roof of the mouth; from the front edge to the back edge of this silver plate four or five holes are made in a straight line large enough for a needle to pass through them; on the back of it is then sewed a piece of sponge; which when expanded with moisture is nearly as large as the silver plate. This sponge is slipped through the division of the bone of the palate, so as to lie above it, while the silver plate covers the aperture beneath, and is suspended by the expanding sponge. This is removed every night and washed, and returned into its place in the morning; on this account it is convenient to have five or six of them, for the sake of cleanliness. I have been more particular in describing this invention, as I do not know the name, or place of residence, of the maker.