La scienza e la tecnica di chirurgia : essendo un trattato di ferite chirurgiche, malattie e operazioni . ieright scapola, che si suppone begrowing; o sterno-claviculararticulation sullo stesso lato o alcune delle cartilagini delle nervature, liave ))een oli-servita al progetto. Ogni volta che il Surgeonis consultati per tali sintomi, giacciono shouldat una volta esaminare la colonna vertebrale, che egli willgenerally trovare ad avere una inclinazione versoil lato destro. In earl3^ fasi di thedisease, quando la deviazione non è verydistinctly contrassegnato, la modalità readiest ofdetermining è di consentire al paziente di standupright, tenendo

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The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . ieright scapula, which is supposed to begrowing out; or the sterno-claviculararticulation on the same side, or some ofthe cartilages of the ribs, liave ))een oli-served to project. Whenever the Surgeonis consulted for such symptoms, lie shouldat once examine the spine, which he willgenerally find to have an inclination tothe right side. In the earl3^ stages of thedisease, when the deviation is not verydistinctly marked, the readiest mode ofdetermining it is to let the patient standupright, taking care that the feet are wellplaced together, and that the attitude isnot forced but natural; the Surgeonshould then run his finger down t!ie iiackfrom one spinous process to another, touching each as he passes it with a pendi|)ped in ink; in this way, when he has reached the lower part, he willhave mapped out the course of the vertebral column, and thus may seeat a glance the nature and extent of its displacement. At the sametime, he will probably observe that the two hips do not exactly corre-. Fig. 514.—Lateral Curvature of Spine. 346 DEFORMITIES. spond, the left being somewhat thrown oat. Yery commonly there is agood deal of neuralgic tenderness about tiie spine, and at this early stagethere may be an?emia and symptoms of impaired nutrition. As the dis-ease advances, the curvature becomes more distinct, and at the sametime, owing to the torsion of the column, assumes a slightly angularcharacter where most convex. The ribs on the right side are thrown outand bulging, and carry up the scapula with them, whilst those on theleft are sunk and depressed (Fig. 514). In fact, the whole of the rightside of the chest and body partakes in the projection of the spine on thatside, and thus adds much to the general deformity; whilst tlae left sideof the chest is correspondingly hollowed and sunk in. When the dis-ease has advanced in this v/ay, it always occasions great general debilit}, e

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