Points in the therapeutics of diseases of the joints / by A.B. Judson.

  • Judson, Adoniram Brown, 1837-1916.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: Points in the therapeutics of diseases of the joints / by A.B. Judson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    3/6 (page 3)
    3 in detail in former papers,1 and sustained by reasons which seem to me conclusive. The third point I wish to make is, that anchylosis has not been given its proper value in the formulae of this therapeutical problem. When long-continued inflamma- tion has rioted in the tissues of a joint, deforming the ar- ticular surfaces and locking them up in organized lymph and shortened ligaments, we have anchylosis, the ulti- mate degree of which will depend, in my opinion, on the promptness and success of our efforts to arrest the in- flammation. And I think that we are wrong when we fear adding to the amount of ultimate anchylosis by early and thorough fixation of the joint. To me it seems rea- sonable to believe that such a course will diminish the re- sulting anchylosis by subduing the inflammation and pre- venting an excess of its products. The statement has been made, and I believe can be sustained by records, that fixa- tion of a healthy joint, no matter for how long a period, is powerless to produce anchylosis. It causes a temporary arrest or impairment of motion, such as can be over- come by habitual effort on the part of the patient, a dis- ability very different from the anchylosis following in- flammatory disease, which is, with rare exceptions, permanent. If this view be correct, then fixation is to be applied as early in the case as possible, and with un- compromising persistence, in the belief that, so far as the joint is a healthy one, fixation is absolutely harmless, and 1 St. Louis Courier of Medicine, May, 1881, pp. 367-372. New York Medical Journal, July, 1882, pp. 1-17; January 31, 1885, pp. 116-120. The Medical Rec- ord, May 12, 1883, pp. 509-512; July 7, 1883. pp. 1-4.