The nature and etiology of bone disease in Kashmir ; The conservative surgery of long bones ; Necrosis of the lower jaw.

  • Neve, Ernest Frederic, 1861-
Date:
[1889?]
Catalogue details

Licence: Public Domain Mark

Credit: The nature and etiology of bone disease in Kashmir ; The conservative surgery of long bones ; Necrosis of the lower jaw. 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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    in which this operation would bo quite out of tho question. In their early stages, most bone diseases will require surgical treat- ment of a different kind. iSome forms of this treatment we have already referred to—as, for instance, the antiseptic opening of sub-periosteal purulent collections trephining, gouging and trenching. We may in addition mention the great value of subcutaneous periostctomy and of linear osteotomy and drilling. These latter operations are especially useful in subacute and chronic periostitis and ostitis whether pus bo present or not. Nowhere can bone disease be more advantageously studied than in the tibia, for here it is so common. This frequency may be accounted for partly by the great superficiality of the bone and its consequent exposure to cold and the action of violence. Given an individual with the poison of acquired or heredi- tary syphilis in his blood and tissues, or with some other predisposition ; add to this imperfect nourishment and then even a slight exciting cause may bring on disease. Sometimes it is not easy to deternvne the nature of the exciting cause. For instance, a few days ago I examined a boy in our out-patient department, who presented rather profound hypertrophic ostitis of the left tibia and left humerus. These bones on the right side of the body having escaped implication. This boy dates his disease from the time of the famine, some eight years ago. On the same day, I saw another lad suffering also from hyper- trophic ostitis, but here the tibia and ulna of each side were affected, and the fibula to a less extent. In this case in which superGcial bones of the extremities were generally affected, it was more easy to account for the condition than in the former. One of tho earliest and most frequent forms of bono disease, especially in the tibia, is a degree of periostitis associated or not with evident ostitis. In many cases this is obviously syphilitic. The patient comes to the Surgeon with complaint of pain in the shin continuous and rather severe; worse at night; great tenderness on pressure. The slight oedema of the skin and fleshy feel of the subjacent periosteum is characteristic. Here, if the symptoms are not urgent, tho application of red mercuric