Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright.

  • Wright, G. A. (George Arthur), 1851-
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright. 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.

    150/276 (page 126)
    9. Excision of the hip cuts short the disease, relieves pain, and gives a better limb than the average result obtained without operation. 10. Excision should be looked upon as an ordinary operation for necrosis, and is not necessarily attended by a higher mortality than sequestrotomy elsewhere. 11. Excision in old pelvic disease, or where the health is broken down, or the patient is over fifteen years, should be rejected in favour of amputation. 12. The presence of a sinus after operation, unless there is much discharge or evidence of extensive pelvic disease, does not imply failure of the operation. 13. The presence of an abscess after a long period of quiescence without other evidence of relapse, (residual abscess), is not to be looked upon as of serious import. [Note.—While correcting these proof sheets, I have had the opportunity of seeing the latest work on Diseases of the Joints, by Mr. Howard Marsh. In speaking of hip disease, Mr. Marsh puts the mortality in cases treated (by continued rest) at 5 per cent, and even in cases with abscess at 6 to 8 per cent, while the death rate from the operation of excision itself in advanced disease is at least 10 per cent (pp. 317 et seq.). I can only account for Mr. Marsh's opinions by supposing, first, that he has been exceptionally fortunate in getting cases at a very early stage; secondly, that his experience of excision has been more unfavourable than my own; and thirdly, that he has had the advantage of being able to treat cases for an indefinite time at the Alexandra Hip Hospital, whereas in general hospitals it is impossible to occupy beds for any prolonged period with chronic hip cases. In short, that Mr. Marsh bases his opinions rather upon the conditions to be met with in private than in hospital practice.]