On disease of the hip-joint / by Lewis A. Sayre.

  • Sayre, Lewis A. (Lewis Albert), 1820-1900.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On disease of the hip-joint / by Lewis A. Sayre. 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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    [6 this increasing effusion, the limb becomes more flexed, abducted, and everted, or rotated outward, to unfold, so to speak, the capsular ligament, thereby enabling it to accommodate itself to the increased amount of fluid within it. This is the second stage of the disease. The adductor muscles become very rigid and contracted under the influence of reflex irri- tation ; constant efforts are made to draw the thigh inward, which are unavailing, as it is impossible for the limb to yield to their tractile force, owing to the effusion within the capsule compelling it to assume the position above described. This stage of the disease is attended by the most acute and ago- nizing pain, the slightest attempt at motion, concussion, or com- pression causing the most distressing torture; even the jarring of the bed, stamping upon the floor, the slamming of a door, or any- thing that causes the least movement of the bed upon which the little sufferer is lying, may be followed by an increase of pain. At this period of the disease the attendants are frequently awakened at night with a sharp, shrill, agonizing shriek. The mother runs to the child—and probably finds it asleep ; she will have scarcely reached her room before the same thing again occurs, and this will fre- quently happen during a single night. The inflammation of the joint produces reflex contractions ; the muscles are all on guard to prevent the joint from having the slightest motion. This incessant, constant, unremitting contraction of the muscles preys upon the child, producing exhaustion, until finally, through sheer fatigue, he may drop off into a moment’s slumber, when, the muscles being relaxed, the limb falls down, motion is made in the joint, which causes such instantaneous pain that the muscles at once give a spas- modic contraction followed by the piercing scream to which I have just alluded. Of course, at this period of the disease it can hardly be mistaken ; but upon stripping the child, and examining as I have directed that he should be examined in the first stage, he will be found to