Description of an apparatus for injuries & diseases of joints, with observations and cases / by Benjamin Barrow.

  • Barrow, Benjamin.
Date:
[1847]
Catalogue details

Licence: Public Domain Mark

Credit: Description of an apparatus for injuries & diseases of joints, with observations and cases / by Benjamin Barrow. 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.

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    OF AN APPARATUS FOR INJURIES AND DISEASES OF JOINTS. By BENJAMIN BARROW, ESQ., Clifton, Bristol, The following observations are submitted Mo the public in the hope that they contain some novelties, the knowledge of which will bo found useful in the management of diseased and injured joints. An almost constant attendance for ten years at St. Barlholemew's and other large Metropolitan and Con- tinental Hospitals, and some years of private practice, have afforded me in the first place, many opportunities for comparing the various modes employed in the treatment both local and general of injuries and dis- eases of joints; secondly, the results arising from these various plans; and lastly, how the means and appara- tus in general use might be improved and deficiencies supplied. I must premise that it is not my intention to en!er more minutely into the history of these cases, either as regards the course they run, or the treatment ordinarily employed, than may be necessary for the clear explanation of the apparatus which I am desirous of introducing to general use, for the valuable treatise upon the subject of the diseases to which joints are liable by Sir Benjamin Brodie, precludes the necessity, I might say the possibility, of any subsequent writer, however greathis experience, adding to it any important information. The prominent position which the joints, especially the elbow and knee,hold in the human frame, augments considerably their liability to receive more frequently thsn other parts of the body external injuries ; no pirts are so prone to inflame as the joints; in no part wherein inflammation has once set up, does it increase so rapidly as in the synovial membrane, which renders it so much the more important that all motion in » joint should be immediately restrained and altogether prevented after the first appearance (however slight,) of inflammation, at the same time that all necessary local remedies are efiiciently applied. To obtain this end has been my object, as also to explain the requisites for carrying out the above measures, and at the same lime to direct more attention than it appears to mc has hitherto been done, to the quiet treatment which diseases and injuries of the joints in every stage require. I believe it will be found that by the aid of the splint,* represented in the cut, Fig. 1, the objects just named may be efiiciently carried out, as also the views and directions of Sir Benjamin Brodie most fully complied with. These views and directions I cannot do better than give in his own words,—he says, Not only in cases of inflammation of the synovial membrane, but in all other cases in which actual disease of a joint exists, the disease, whatever it may be, is kept up and aggravated by motion and exercise, and whatever means can be employed so as to keep the joint in a state of complete repose will go far towards the produc- tion of a cure. In the early stage of acute inflam- mation of the synovial membrane, indeed no inter- ference on the part of the surgeon is necessary for this purpose, the pain which the patient experiences, in every attempt made to use the limb being sufficient to prevent him using it. But it is otherwise when the inflammation has in a great degree subsided. At this period the motion of the joint occasions little or no inconvenience at the time, although it invariably tends to aggravate the symptoms afterwards. It is difficult to persuade a patient thus situated to submit to a very rigid system of confinement, and if he should do so, there is always danger in protracted cases that his general health may suffer in consequence. It is im- portant that he should not be altogether deprived of the opportunity of taking air and exercise; yet it is necessary that the affected joint should le kept in a state approaching as near as possible to one of com- plete repose. This double object may be attained by means of a proper bandage applied so as to restrain the motions of the joint, at the same time that it makes no more t^an a moderate degree of pressure on it. As to the best mode of carrying this plan into execution, the surgeon must exercise his own judgment in each individual case. If the disease be far advanced, and there is danger of the cartilages • The Society of Arts of I^ondon awarded the silver medal for the year 1841, for this apparatus.