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Excerpt from Pachymeningitis Spinalis Externa: Recovery Complete
As Dr. Freiberg has stated, the diagnosis of tubercular disease of the vertebra was made with some reserve by both of us. Gowers4 states on this point: When clear indications of caries precede the paralysis the nature of the case can hardly be mistaken When the two develop together mistakes are often made, but are usually due to the want of repeated examination of the spinal column. It is when the root or cord symptoms precede distinct evidence of bone disease and when the latter is so slight as to be equivocal that the chief real difficulty in diagnosis occurs. It will be seen that the case here recorded comes under the third condition de scribed above.
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