The prevention of deformity after infantile paralysis by recumbency during the stage of recession / by Adoniram B. Judson.

  • Judson, Adoniram Brown, 1837-1916.
Date:
1907
Catalogue details

Licence: In copyright

Credit: The prevention of deformity after infantile paralysis by recumbency during the stage of recession / by Adoniram B. Judson. 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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    [REPRINT FROM DENVER MEDICAL TIDIES AND UTAH MEDICAL JOURNAL] ’<3cfelio»-G.fl907) / . THE PREVENTION OF DEFORMITY AFTER INFANTILE PARALYSIS BY RECUMBENCY DURING THE STAGE OF RECESSION. By ADONIRAM B. JUDSON, M.D., New York City, N.Y. In the ever-changing treatment of disease the influence of environment is receiving unusual attention, as is seen in the management of tuberculosis of the joints. The influence of the lapse of time is also better understood. Medicines are given in small doses for very long periods, and the effects of time on the body are more clearly seen to influence the course of dis- ease and the action of remedies. In the treatment of infantile paralysis I propose a method which relies exclusively on the influence of environment and the lapse of time. It is applicable only in the very early stage, before the case is likely to be seen by an orthopaedic surgeon. As soon as the disease is recognized I would limit the patient to the recumbent position till there is no possibility of further recession of the paralysis. The period of spontaneous reces- sion extends over several months. During this time the diffi- cult task must be undertaken of keeping a child, well in every other way, off his feet at an age when he should be learning to walk. In some cases 18 months should be occupied in this way. The common belief that such a patient requires exercise, especially of the affected limbs, will give rise to criticism and objections. A simple argument will not prevail in the family circle, and the physician’s word will hardly prevent the little patient from having many a romp. And when the case ends there will be differences of opinion. If some lameness results, it may be said that the patient should have had more exercise, and if there is no disability at all, after the strict observance of recumbency, it may be said that there had been very little the matter with the child. The argument is as follows: It will be recalled that the ill effects of joint disease are seen more commonly in the lower extremities than the upper because tuberculous action is sub- ject to resolution in the epiphyses of the shoulder, elbow and wrist, but often goes on to destruction of the articulating sur-