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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    tissue inflammation, are all called rheumatism, with- out any attempt to discover the cause. It is not exaggeration to say that nine out of ten cases of joint disease that come to me have been maltreated for rheumatism for weeks and months, when they have presented no symptoms of rheuma- tism from the beginning, except possibly the one complaint of pain. A few cases selected at random from my note books will illustrate the criminality and carelessness of attributing to rheumatism con- ditions that should not in any wise be confounded with that disease: Case I.—Girl, two years of age, treated by two or three different physicans for rheumatism. Joint disease at both hips, with thighs flexed at right angles to the body. In her attempts to stand, patient had thrown her shoulders backward, lordosing the lumbar spine; finally, sent to an instrument maker for a brace to cor- rect the lordosis, the actual disease at the hips being ignored or unrecognized. Case II.—Boy, fourteen years old. Thigh fluctuat- ing bag of pus, undulating, visible to the eye, without palpation. High fever and temperature for weeks. Thoroughly septic, yet still being tr-eated for rheuma- tism. Immediate incision revealed lower epiphysis of femur entirely destroyed and separated from shaft. Case III.—Girl, seven years old. Treated for year by prominent physicians for rheumatism of hip, al- though history was typical of tuberculous hip disease, and every book symptom present. Five years of subse- quent treatment required to secure even a fair result, with ankylosis in bad position. Case IV.—Boy, three years old. Treated for six months by a physician for rheumatism of knee, even two months after abscess and sinuses appeared. Re- sult, two years of suppuration, two erasions, ankylosis. Case V.—Boy, eight years of age. Treated two years by surgeon for rheumatism of knee. Has been permitted to walk about. Joint fixed at right angle, densely infiltrated throughout whole region; ligaments destroyed; partial subluxation. Erasion, joint destroyed,