Joint diseases, especially those of children / by De Forest Willard.

  • Willard, De Forest, 1846-1910.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Joint diseases, especially those of children / by De Forest Willard. 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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    frequently accompanying hip disease are, of course, the expression of pain. You all understand their significance. The muscles that have by their rigidity so persistently guarded the joint against motion now relax during sleep, until the resultant pain arouses them again into activity, the sore head of the femur is driven suddenly into the acetabulum, and the patient arouses with a shriek. It is to con- trol this muscular spasm that continuous extension is applied. The important point to be emphasized is that the disease can be diagnosticated early, and that it must be diagnosticated early in order to be aborted. That hip and other joint disease can be aborted if taken in its inception is absolutely true. The same may be said of the’knee and ankle. We'need hardly speak of the upper extremity, as the conditions, save at the wrist, are -rare. The diagnosis is of the utmost importance, since on the early diagnosis rests the treatment of the case, and upon treatment depends the whole prog- nosis. Undiagnosticated, or improperly treated for the first months, destruction of the joint is exceed- ingly probable, and under the most favorable cir- cumstances years will be consumed before the con- dition of safety is reached. An early diagnosis is just as important and perhaps more so than in ap- pendicitis or osteomyelitis, especially since in the former disease many appendiceal infections will take care of themselves, while a tuberculous hip disease unrecognized and neglected is almost sure to progress badly. It seems impossible to me that family physicians and even excellent surgeons can take the risk of such serious consequences, when a few moments’ observation and care would suffice for a correct diagnosis. The family physician at the present time is perhaps even more alert in appendi- citis than the surgeon in discovering this disease (oftentimes when it does not exist at all!), while in