Traumatic separation of the epiphyses / by John Poland ... with 337 illustrations and skiagrams.

  • Poland, John, 1855-1937
Date:
1898
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Licence: Public Domain Mark

Credit: Traumatic separation of the epiphyses / by John Poland ... with 337 illustrations and skiagrams. 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.

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    met with in the hving subject. We shall allude to this again later on. Epiphysial separations were described nearly at the same time by MM. Eoux and Gueretin. M. Eoux de Brignolle wrote his thesis at Montpellier entitled Dissertation sur la disjonction des epiphyses, February 8, 1822. It contained a description of two specimens obtained by ampu- tation : (1) Coural's case of separation of the lower epiphysis of the femur, which had occurred in 1816 ; and (2) a very remarkable case of disjunction of the lower epiphysis of the radius, the styloid epiphysis of the ulna, and the upper epiphysis of the first phalanges of the thumb, index, and middle fingers. This occurred in 182]. Both these cases are fully described in their proper chapters. Boux says that his thesis was written to prove to some sceptical minds the possibility of such a lesion of the osseous system after the first few years of life. He insisted upon, ' first, the danger of ignoring epiphysial separation when its reduction ought to be possible ; secondly, the progress of the phenomena which result from such an error of judgment; thirdly, the possibility of separa- tion of the epiphyses occurring up to the eighteenth year; fourthly, the possibility of such separation taking place on the largest cylindrical bones, as well as on the medium-sized and smallest.' Writing in 1825 {loc. cit. infra), Jarjavay says: 'Aussi en clinique, il est bien difficile, sinon impossible dans certains cas, de determiner si la lesion est un decoUement plutot qu'une fracture. II ne faut pas perdre de vue, si Ton cherche a arriver a ce diagnostic, ce fait anatomique, a savoir, que les epiphyses ne com- prennent generalement que les deux tiers seulement des extremites des OS longs, et que la diaphyse fournit I'autre tiers.' Goyrand in 1836 published his first observations on separation of the lower epiphysis of the radius. Gueretin's valuable work, ' Recherches sur le DecoUement spon- tane et traumatique des Epiphyses' {La Presse Medicale, 10 Mai, 13 Mai, 17 Mai, 1837, i. No. 7, &c. pp. 290, 297, 305), was pubhshed in 1837, and added some important facts. This author collected a number of cases (forty-five) published up to this date. Many of these were fractures in adults, some were separations through disease. He also endeavoured by numerous experiments on the dead body, as well as by careful examination of clinical cases, to clear up the many obscure points with which the subject was then surrounded. But from want of sufficient material his descriptions were very incom- plete, and many points of interest were not even mentioned. Nearly a century after Eeichel's thesis, M. Rognetta (' Memoire sur la Divulsion traumatique des Epiphyses,' Gazette Medicale, Paris, 1834, p. 433) published an elaborate memoir upon traumatic separa- tion of the epiphyses. To this interesting memoir we are indebted for much valuable information, and in it we find brought together
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