Fractures, dislocations, deformities and diseases of the lower extremities / by Hugh Owen Thomas.

  • Thomas, Hugh Owen, 1834-1891.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Fractures, dislocations, deformities and diseases of the lower extremities / by Hugh Owen Thomas. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    very initial period spring out by th- weight of the limb, but the greater change requires further time. In this country it has been found that immovably fixing the hip joint annuls pain and spasm, except during the period of distension of the hip- joint when it is about to rupture. Fifth. It is the most impoilant sign of hip-joint disease, taking pre- cedence over every otlier sign or symptom, both from a diagnostic and prognostic standpoint.'' This is the most important of the paragraphs. It is upon the proper interpretation of this paragraph that the whole ques- tion of the treatment of diseased joints rests, and upon which all erroneous methods are sure to be wrecked. A correct inter- pretation of this paragraph, enables a surgeon to diagnose the very day of the onset, and the week of recovery. In none of Dr. Shaffer's contribudons to surgery does he even imply that he understands the trustworthy flexion test—an infallible guide to diagnosis and prognosis, and an antidote to the American system of treating this disease by motion and traction, no matter how carried out. Sixth. And it has been proven many times that anything which increases iiiter-aiticular pressure, also modifies this muscular sign (and as it has also been proven that anything which increases inter-articular pressure, increases also all the symptoms of the disease), it becomes our duty to base our treat- ment upon the pathological expression of the disease. We are in possession of a clinical fact, never disputed. It is this : That the period of most uninterrupted tenderness and spasm of the muscles is when the joint is hyper-distended with fluid, and consequently the articular surfaces not in contact, yet