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

XXXVI
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THE CHARLOTTE MEDICAL JOURNA].
in all. The prevailing assumption that the and without the necessity of a communicapathology
of injury to the semilunar carti- tion between the two regions. In conclulage
is a displacement, the author has found sion, he condemns the therapeutic test by
to be entirely wrong. In all of his cases the administration of iodine, which should j
the lesion was found to be a fracture; the never be used unless the microscopic examdislocation
is merely secondary. The writer ination proves very uncertain. It should j
says that displacement, without fracture, if then be pushed rapidly and its effects watch- j
it occurs at all, must be a very rare event, ed for only a limited time, Early diagnosis
Of 100 cases, in 98 the internal cartilage and operation is the only hope.
was fractured and in two the external. The .
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diagnosis is made by the typical history of
,,,^j„ ,„ surgical Tuberculosis.
sudden locking, the inability to extend the
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ti ^r . t. . , „ „ , , u , "
c „
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r ., • t f 11 Dr. \V. A. Tatchell saya that tuberculosis of the
knee, and swelling of the joint following
^^j^^^^ ^^^^^^ g,^,,^^ ^^^ 3^i„ j^ the most comthe
attack. In a fair percentage of the mon disease in China and highly recommends the
cases, osteo-arthritic changes may occur, application of iodin liniment after operative treati
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resulting in more or less permanent dis- "'''"' A/*^'' i-i-, »TM i 1 1 r 1
ability. The treatmen of recent cases con-
°P,^,'''>V"g. ?^s'^/.^PJ."8. the cavity is
thoroughly swabbed With lortm liniment. .-V piece
^j ^b.sorbent cotton twisted around the end of a
i
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SlStS in first reducing the dislocated cartl- probe forms a good swab, and can be graduate^ i
lage. This can usually be done by flexing according to the size of the sinus. The liniment is |
the joint to its fullest extent and then sud- aPpHed every day. The application does not cause i
li ^j. . Tc . , . pain, except a momentary sensation when applied t
denly extending it. If not rotatory move- P,
^„;„^ J,i^^^^, neither does it destrov tisstles, as ,
ments should be made in the fully flexed does pure carbolic acid. Granulations do not be- i
position before extension is performed. If come excessive. At the first application he inserts i
this also fails, these movements should be a thin piece of gauze or packs lightly, but never at ;|
repeated under anesteesia. After reduction, t^^^:^1::^J^ t^:^:::^ 'Cr \
splints are applied for SIX weeks. If dls- many chronic sinuses. From the first he gives a
placement rectirs, the case may be treated mixture internally, containing syrup of iodid of i
bv the aid of a support or by operation. For 'n. ' ^rani, and potassium iodid, 5 grains, three )
persons whose livelihood depends on a times a day.-British Medical Journal. •
strong knee, the support is useless and a
radical operation is advised. This opera-
*
Treatment ol Children Suifering from 1
tion consists in a hockey-shaped vertical Rheumatism or Chorea.
,
incision on the inner side of the knee, open- Dr. D- B. Lees states that every case of chorea in
ing of the joint and removal of the anterior
childhood should be considered as presumably
t„. tv.v^ f .1 fl- t 1 .-1 r\c 11 rheumatic, and ought to have the benefit of this
two-thirds of the affected cartilage. Of 41
probability. Every such patient should be at once
operated patients in whom the subsequent sent to bed, and treated vigorously for rheumatism.
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history could be traced, 38 reported them- He claims that almost the whole of the heart dis- j
selves able to work, while three were cases which exist in patients under thirty years of
still
a: ui I '1^1 »• 1 r 1 age, as well as a very considerable proportion of the
disabled. I he average tune before work ^Lk disease of later life, is the result of rheumatic
was commenced was about 1 2 weeks. infection of childhood that was either unrecognized
or ineffectively treated. The author emphasizes
Operative Treatment ol Inlra-Oral the point that every child who complains of sore
Cancer.— Childe ( British Medical Journal throat or of pains in the joints, muscles or tendinmeiltions
the two principals of operative ous structures, every child who suffers from malaise
treatment of oral cancer. The neck should '^::^7^J^:^:;^:^J::Z^
always be operated on first, then followed nodules on his tendons or round his joints, or subat
once or later by the excision of the pri- periosteal nodules on his bones, every child who
mary growth. By ligation of the lingual '^^^ P^'" '" ^^'^ chest, or shortness'of breath, or
°'arked pallor,
and
and everv child exhibiting even
facial arteries on the alTected -.--i^v-va side luc the Liic
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gjjgjjt choreic movements or merely weakness and
severe hemorrhage is obliterated if the sec- incoordination of muscular action or emotional inond
stage of the operation is undertaken at stability should at once be put to bed and his heart
once, and, if delayed, tends to starve the should be promptly and carefully examined. The
^""'°"' •"''" cancer cells and diminish
P?y"ton and Paine's demonstration of
their activity ' in
a diplococcus in rheumatism and chorea which is
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