A protest against the routine excision of joints / by Robert Jones.

  • Robert Jones
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A protest against the routine excision of joints / by Robert Jones. 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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    [Reprinted from the Liverpool Medico-CMrurgical Journal, July, 1888.] A PROTEST AGAINST THE ROUTINE EXCISION OF JOINTS. By Robert Jones, Honorary Surgeon to the Liverpool Stanley Hospital. Mr. President and Gentlemen, To deal in any sense exhaustively with such a subject as the treatment of the diseases of the joints in the short time at our disposal is of course impossible. And yet to criticise excision without offering some better alternative, would be to afford members no grounds for exchange of opinion. Indeed the best arguments against the operative school consist in noting the principles, the observance of which render excision unnecessary and the neglect of which are, in point of fact, ample apology for the strong effort made on behalf of operation. I will, therefore, roughly and rapidly sketch those points which I deem it essential to remember in the successful treatment of articular disease. And here, at siarting, I would frankly admit that my connection with Mr. H. 0. Thomas may have given me a bias in favour of rest as against operation, a bias made more intense by the frequency with which unsuccessful excisions have been forced upon my attention. Still, a bias is not apart from the influences of evolu- tion, and current medical literature is in some measure an antidote to any conservative experiences one may cling to in relation to articular disease. What, then, are the principles which should govern us in the treatment of these lesions. I group the joints because the laws which obtain in the successful management of a diseased phalangeal joint are identical with those applicable to the hip, and a surgeon prepared to apply diverse methods has not yet grasped the secret of success. The first and all important essential is “ rest,” and all that is in conflict with this in treat- ment retards recovery. Later I shall have occasion to deal with some of the factors by which surgeons often unconsciously violate this cardinal doctrine. At present I shall content myself by saying that enough rest is wanted to make more useless.