File:American practice of surgery - a complete system of the science and art of surgery (1906) (14595720060).jpg

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
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Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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thatthe lesion was syphilitic. He was putupon inunctions of mercury, and po-tassium iodide was administered bythe mouth, with the result that theulcerations on the front of the kneevery promptly healed. The infiltra-tion of that portion of the synovialmembrane which had become in-volved at the second observation dis-appeared, and the patient, while keptunder the influence of these drugs,has remained entirely well. His gen-eral condition improved coincidentlywith getting his syphilitic infectionunder therapeutic control. A similar pathological conditionhas been seen by the writer in thecase of a young man who had anunquestioned history of syphilis, andin whom, since the first observation,Charcots lesions have manifested themselves in one knee joint: This patient presented himself for treatment after having had a swelling of oneknee of a chronic character, but which had apparently been induced by a severestrain that had been imposed uponthe joint. (Figs. 239-242.) The synovial membrane
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Fig. 239.—Case of Syphilitic Disease of tin- KneeJoint. Tlif photograph shows the typical swellingof the knee with hyperextension very well demon-strated in the lateral view. (Original.) NON-TUBERCULOUS INFLAMMATIONS OF JOINTS. 541 was greatly thickened; there was very little excess of fluid in the joint; the patientsgeneral condition was excellent. He was having some pain in the knee, but nomore than it seemed would be natural with the amount of swelling which was therepresent. There was a slight amountof permanent flexion, but otherwisethe motions of the articulations weregood. There was a slight increase inthe surface temperature. The x-rayshowed absolutely no change in thecontour of the osseous elements of thejoint, but did show an extensive infil-tration of the synovial membrane.The patients reflexes were tested andit was found that he had no sign ofthe infection of his central nervoussystem by syphilis. An arthrotomywas done and a condition was foundwithin the joint very simil

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