On the pathological basis of the treatment of joint diseases / by Henry G. Davis, M.D.

  • Henry Gassett Davis
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: On the pathological basis of the treatment of joint diseases / by Henry G. Davis, M.D. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    To illustrate, cases of fracture of the neck of the femur are reported, that had been under treatment by the straight splint for months. In the post-mortem reports, the state of all the articulations below that of the fracture are detailed, while that of the hip, the seat of the injury, is omitted. Had the condition of the hip-joint been given in every instance of fracture of the neck of the femur treated by the straight splint, and the result of dissection recorded, together with the description of the other articulations of the injured limb, the array of facts would have been abundant. As it is, I have obtained two cases from the books, in which all the facts having a bearing upon my theory are fully detailed; facts that quite conclusively support the views I shall ad- vance as accounting for the phenomena witnessed. There are, however, a sufficient number of cases in point, in which the facts (so far as related) correspond with the two mentioned. In adition, several surgeons have kindly supplied me with further tes- timony, derived from.their own observations; and what is gratifying, as well as encouraging, to an investigator in a new field, they have been disposed to acknowledge the correctness of the conclusions to which the facts have led me. DuriDg the course of inflammatory processes in and about the joints, after they have advanced to a certain point, the joint becomes in a measure fixed, and not unfrequently so much so, as to resemble true anchylosis. The time necessary to produce this result varies ac- cording to the character of the structure inflamed. Nature appears to establish this immobility of the parts as a reme- dial measure, and, so far, it is safe to follow her guidance. In order to do this understandingly, however, let us inquire what is her aim and intention in thus rendering the joint immovable. It undoubtedly is to protect the surfaces of the joint, (that come in contact in the natural movements of the limbs,) when diseased, from friction. The pain which friction causes prompts the sufferer to second this inten- tion of nature by his voluntary efforts. So far as this object can be accomplished by the muscles holding the joint motionless, they so act. Now, in effecting this immobility, are the muscles of the diseased joints relaxed, and therefore at rest; or, are they in a semi-contracted state, and thus fix the joint by acting equally upon every side of it ? It would appear, from some facts I shall adduce, that the latter is their condition. In inflammation in and about joints, when it has advanced to a de- gree that renders motion painful, if any attempt is made to flex or