Identifier: diseasesofhipkne00thom (find matches)
Title: Diseases of the hip, knee, and ankle joints and their treatment by a new and efficient method
Year: 1875 (1870s)
Authors: Thomas, Hugh Owen, 1834-1891
Subjects: Hip joint Knee Ankle Hip Joint Knee Ankle Joint Diseases
Publisher: Liverpool : T. Dobb & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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nates.We have also to guard against the possibilityof mistaking abscesses connected with the c 14 spine, or arising within the pelvis, sciatica, orhysterical simulation of this complaint, forMorbus Coxae. The diagnostic method which I shall demon-strate is of value to the surgeon in the cases ofchildren in particular, as he can get all informa-tion in defiance of the struggles of the patient,and without administering an anaesthetic, and itenables him to know how long a time the patientmay have been suffering, whether two weeks ortwelve months. For all practical purposes thesymptoms are often as well defined in twelvemonths, as they are in as many years.—Plate 3illustrates the manipulation in this diagnosticmethod. Having undressed the patient and laid himon his back on a table or other hard planesurface, the surgeon takes the sound limb andflexes it, so that the knee joint is in contactwith the chest. If the patient be thin and spare,let the limb be pressed and maintained on the -to
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15 chest firmly, but if the patient be stout, let therebe a little less pressure. Thus the surgeon makcertain that the pelvis is in normal line with thespine, and fixed thus, the sound limb becomes a lever wherewith to maintain this normal position.Now let the surgeon attempt to pass his handbetween the lumbar spine and the table. If notable to do so, then the diseased limb must take hisattention, while an assistant maintains the flexionof the sound limb on the chest, which controls thespine and pelvis. He then requests the patientto extend the diseased limb, at the same timeassisting him very gently and slowly to its utmostrange of extension. The amount of flexion shewnin the illustration plate 3, (an angle of 160degrees with the pelvis) indicates, according to myobservation, an inflammation of about six weeksduration. The ano-le gradually decreases as thedisease progresses, if uncontrolled ; the amount offlexion indicating the duration up to twelvemonths, which at that period often

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