The etiology, pathology, and treatment of diseases of the hip joint / by Robert W. Lovett.

  • Robert W. Lovett
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The etiology, pathology, and treatment of diseases of the hip joint / by Robert W. Lovett. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    140/230 (page 136)
    whole course and progress of which are widely divergent from those of malignant disease. This quotation from Mr. Howard Marsh * is a fair state- ment of the position in the matter as it appears to most surgeons. The justification of early excision of the hip cannot be found on these grounds, evidently. It must rest on diminished mortality or improved results, and these as- pects of the question have just been considered. Yet, from his experience with excision of the hip, Wright has reached no more temperate conclusion than that treat- ment short of excision, where once suppuration occurs, is useful only as a palliative or means of temporizing. Now, these statements of Mr. Wright and Mr. Barker are much more radical than those of the Clinical Society's Com- mittee, who reported in 1880, among their conclusions, that with respect to the general question of operative interfer- ence [in hip disease] the committee are of opinion that the effect of complete rest and weight, or other modes of ex- tension, with the withdrawal of matter, should always be patiently tried in the first instance, and that operative in- terference should be resorted to only .when these means have failed to secure the favorable progress of the case. Certainly, Mr. Wright's figures in no wise justify the position which he takes, as must have been especially seen when the consideration of the end results of mechanical treatment was taken up. It seems unnecessary to dwell longer on the fact that exci- sion of the hip cannot be accepted as the proper treatment of hip disease. The writer can only state his views, which he believes to be representative of those of most American orthopedic surgeons. Excision of the hip is to be considered a proper and necessary measure under two circumstances,— where mechanical treatment is not obtainable, and where mechan- ical treatment, after careful and intelligent trial, has failed. * Brit. Med. Jounial, July 20, iSSg, p. 121.