Congestion of the bodies of the vertebrae is sometimes observed in the lower dorsal and lumbar part of the column, and it usually occurs when the vertebral plexus of veins is dilated and swollen; it is sometimes only an habitual distension unconnected with other disease; but more frequently it is produced mechanically by disease of the heart and lungs.

Inflammation of the vertebrae is a disease of frequent occurrence, not only in the young, in whom it is most observed, but also in adults. Indeed, old age is not exempt from it. Any portion of the column, or even any single vertebra, may be the seat of inflammation; but the parts mostly affected are the upper cervical vertebrae, and, next in frequency, the lower dorsal and the adjoining upper lumbar vertebrae. It is very commonly the primary disease, but sometimes it is brought on by previous inflammation and suppuration of the ligamentous apparatus of the column, and of the intervertebral substances. In most cases, it runs a chronic course, very often it is of tubercular nature, and terminates in caries and necrosis. When this is the case, matter usually forms and collects near the column, especially on its anterior surface; and, in favorable cases, opens externally: the track of the matter is sometimes very long, and the external opening far distant from the disease. The carious destruction may then be repaired by anchylosis, and by the column falling together at an angle, corresponding to the quantify of substance lost; but far more frequently the disease exhausts the patient, the symptoms usually showing that the spinal cord and its membranes suffer in some way or other. Thus the cord itself may be compressed from the tumefaction of the ligamentous apparatus, from the protrusion of an abscess into the canal, from dislocation of fragments, or of the whole, of a vertebra, or by the products of circumscribed inflammation of the dura mater of the cord; or it may be bent and irritated at the spot where the angular projection is beginning; it may waste, or circumscribed inflammation may take place in it, or diffused inflammation in its membranes, etc. Moreover, when the upper cervical vertebrae are carious, the odontoid process, being set free from its own ligaments, may, by a sudden turn of the head, tear through the inflamed and softened ligament and the dura mater, which confine it behind, and projecting naked into the canal, may crush the spinal marrow. When the upper dorsal vertebrae are carious, the abscess sometimes opens into one of the bronchi, and matter and necrosed fragments of vertebrae are discharged through the air-passage. Caries of the abdominal part of the column is very often combined with what is called psoas abscess.

Rickets in the spine may be distinguished by the peculiar change which it effects in the texture of the bones and by the curvatures produced in it by rickety deformity of the pelvis. As there is generally more distortion on one side of the pelvis than on the other, the curvature in the loins is usually directed forwards, and to one side.

It has already been remarked, that all the bones of the trunk are subject to mollities osslum, but especially those of the spine. It occasions different deformities, both of the pelvis and of the vertebral column, according to the particular condition of the patients. They are, for the most part, bedridden, so that the usual effects of the disease are an arched incurvation of the whole spinal column and elevation of the pelvis, produced by the pressure upon the sacrum and tubera ischii.

On the subject of adventitious growths, reference may be made to what has been already stated; those chiefly met with are tubercle and cancer. The former is of very frequent occurrence; it gives rise to extensive caries and necrosis of the column, and to the various consecutive appearances and terminations which have been pointed out as those of inflammation of the vertebrae. Cancerous deposits are more rarely met with in the vertebrae than in other bones. The same relations obtain, between cancer of the vertebrae and fungus, as it is called, of the spinal dura mater, as between the same disease in the cranium, and in the dura mater within the head: the former, when situated in the bones, may spread to the spinal dura mater, and the fungus of that membrane may reach from its original seat to the vertebrae, and become a fungus of bone.