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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    V Willard: Joint Diseases. ing of the joint and the application of carbolic acid, followed by pure alcohol, the germs having been removed, the joint can then be closed. Gonorrhoeal arthritis undoubtedly requires speedy removal of the infecting germs. While it may pos- sibly get well under aspiration, the result is uncer- tain and ankylosis will probably result. Pneumo- coccic infection is also exceedingly liable to de- stroy the joint. Conclusions, i. Early diagnosis is the most im- portant of all considerations. Physicians are re- sponsible for a large majority of joint destructions chiefly from carelessness or indifference in the ex- amination of their patients. A child with any peculiarity of gait or carriage should be examined naked. 2. Every physician should abandon the thought that pain in a single joint in a child means rheuma- tism. A limp or peculiar gait with rigidity of peri- articular muscles in a child always means some form of invasion, probably tuberculous, possibly septic. 3. Abort tuberculous infection by immediate ab- solute rest and fixation of the joint. 4. Put the patient out of doors, day and night, for a long period of time. 5. Wise conservatism consists in the prompt ap- plication of all methods of relief, whether hygienic, mechanical, or surgical. In children conservatism should be the rule, since youth has remarkable recuperative power. In adults, however, operative measures are much more frequently demanded. A limb that can readily be saved in a child, in the adult will demand amputation. If an operation will best accomplish a cure, such operation is true con- servatism. 6. In septic cases following streptococcic, staphy- lococcic, pneumococcic, or gonococcic infection, open early and freely. 1818 Chestnut Street.