Vol. 60, 1909 - University of North Carolina at Chapel Hill

ACTS
267
The Etiology ot So-Called Congenital
erable
Dislocation
factor in
oi the
favor
Hip.—Thompson,
of the condition being
static
The London
rather than
-Medical Lancet,
congenital.
savs The
that f\"-- '.'^;"-' ^"-"'/-""Senuai. female
this condition is of - much greater at
frequency
freauencv a greater
mechani
in girls Ihan in boy; It is generally directmale.
The
"^ ^ '7.'^^^'
J°"^^ ^'^ acts
l^
disadvantage than does the
ly due to pressure ' "^,'^°"gen,tal
exerted on
theory
the
entirely
hip fails
joint T"" i
during the adoption of the erect atti ude ^ the greater preponderance
duuuae of the
of
J
_'^^. ....^u .. ,' or
_ _ ,
iggjo,, ,„
such a nature
females,
as
but the
to produce displacement
preponderance is
explained
of the head
by
of
a
the
reference
normal to
femur
the
from compara-
z
tive
nearly normal
anatomy of the joint in acetabulum. The the
usual
two sexe:,
his
Moreover,
tory of
the
such a case
suggestion
is this:
that The the
patient
condition
is
well-developed girlin whom the condition '1^'""'' '^', ^"^^"^"^
IVnSfLZZ^^^f^^ '^""'''^'^"^ becomes ;comes more ^^'^^i
marked as she
'^^y be
as she assumes
met wuh.
the
erect attitude. The child is rarelv seen A Case ol
until the third or Tubereulous
fourth year, when Nephritis
the phy-
as a
Sequel
sician
to
has Angina. to decide between -Theodor
the congenital
(Archiv f.
or
Kinderheilkunde)
acquired formation
says that
of the
the
malady. He
frequency
with
generally
which
chooses
nephritis
the
follows
former, basing
upon a mild
his
case of
opinion on
angina,
the results of a few dissecUons, , °,„ """'^ more P^rticuh
particularly in chil-
rf,' '^'^'- "/T'
on cases seen at a very
"^^^
voung ^^ ascertained
age, and
by arrying
on
out
certain pelvic conditions.
°f ^''^ He -i^ne
after
believes
every
that iTl' attack ^r"^'"^^-"?
the
of
condition
angina.
arises
Just as it
after birth from
has
certain
become a
Professional
ar.atomical'pecuTi;;iHes"of";iVe>em"lTepelvis;
measure to examine
l^^"^'"^"
When the mar.ably erect
after
attitude an attack
is assumed of scar-
the Jf"""^
female hip joint is not
°^
so well
buiiien,
calculated
this
to f ' ,?. , ''^°''^^ ''"'""""" l'' K "T"''''^
resist the upward thrust of the femur
^^ ^«" n cases of angina,
as is
in order to
the male
guard
joint. It depends
against
much grave
more sequela.
for He observed a
its security on
case of
the rim
nephritis
of the acetabulum,
taking an
which
unusual course after
is cartilaginous
a
during
mild attack
the
of an-
first two gina.
years The presence
of
of
life, than
tubercle
does bacilli
the male could
joint. In
be demonstrated. The child succumbed
other words, the head of the male femur is „,r,.« ,.»,.o 1 , , . -,•
much more securely fixed in the hip
-^?'' ^^^^' '° ^^'"^^ '"'^'^''y *"'^^'''^"
bone ,,',7^^
than A previous
is the head
observation
of the female. The
concerned
ace
girl
tabulum
13 years of age
lies in tlie male
who had suffered
hip bone,
from
while in
a mild attack
the
of
female
sore throat
it rather
eight
rests upon days be-
it. Morefore
going to
over, the
the seaside
joint
for
in the female
her
works summer
at a
vacation.
greater The trouble
mechanical
"--— meclianical
lasted
disadvantage
disadvantage.
^ only -."j- two iv^ days uay:
Hence „„a T
the so-called congenital dislocatioi
dislocatfon is reallv f"^,:"'
in many
"'IftrhTr
cases a static dislocation.
'":'' "-"'"' " ' ^"^^ perature. After her arrival
He — at the — ^-ro^'-uc '''V
."u^ ^
seaside
;.Y,-,j
illustrates his meaning by .some well-defined !. "/,^''f 1?" ,;"..^?I^'"^ T' V^° «^^^f ,«"«
iid then fell ill,
diagrams.
with
With
sudden fever
regard and las
to treatment, two
situde. The
classes
only
of cases may
symptom of
be
disease
made.
that
In the first
could be
anatomical
demonstrated was a slight
reduction can be
cedema-
easily and
tous swelling of the eyelids.
permanently accomplished, The examina-
while in the
tion of the urine,
second
however,
this showed is impossible,
the pres-
even under the
ence of
most
albumen contents
skillful manipulation.
above 1 2 per cent.
Illustrative
^s soon as the
cases
third
are given.
day ursemic
If the author's
convul-
views are
true, many other change: vZ^h '^^-"^
h^^.^^n ^^^ -^'^^" ''
^i^L"^!!!',^'^'
regarded as primary and as possible causes
of the dislocation are really secondary.
These are enumerated as follows: Small
and triangular acetabulum, small os in-
nominatum, head of femur
hours from uraemia.
Heart Disease.— Barr (Hrit. Med. Jour.)
says that drugs should only be used when
ijecessary, and always under strict medical
attened and supervision. People, unfortunately for
smaller than usual, shortening and ante themselves, have taken drugs indiscrimi-
version of the femoral neck, coxa valga, nately, without advice of the profession—
hour-glass constriction of joint capsule, grave mistake, especially in heart diseases.
stretched or absent ligamentum teres, and Cardiac tonics are thus taken; and the^
shortening of leg below knee. These con suiting continued high arterial tension,
ditions are discussed seriatim by the author maintained over a long period,
He
may work
summarizes h
, .
, , „, views as follows: I he disaster for the aorta. It is better to lighten
history of a we 1-developed girl with dislo- the load of a jaded horse than to apply the
cation of the hip rarely goes back before „,hip; remedies which lessen the work of
the adoption of the erect attitude. The fact the heart are often more effective than earthat
the child is well developed is a cousid- diac tonics. When the balance between
a