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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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observation. If such conditions could be recognized, operative surgery would of coursenot be undertaken, as doubtless the internal administration of potassium iodideand inunctions of mercury would have caused the villous change in this articu-lation to have disappeared quite as readily as did the knife, and more perma- NON-TUBERCULOUS INFLAMMATIONS OF JOINTS. 543 nently. As our knowledge of the various possible manifestations of syphilisenlarges, we should hold ourselves in readiness to recognize it as the possiblecause for joint lesions in a certain number of cases. We should, however, becautious in jumping at the conclusion that syphilis is present when it is not.The usual points in establishing a syphilitic diagnosis are, of course, to be soughtfor in the personal or family history of the patient. The ordinary signs whichare looked for as evidence of the presence of syphilis should be invariably sought,viz., loss of hair, presence of Hutchinsons teeth, repeated sore throats, stoma-
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Fig. 242.—Radiograph of Both Knee Joints. The same case as that shown in Fig. 235. (Original.) titis, the characteristic scar formations about the alae nasi and the corners ofthe mouth, the presence of corneal ulcerations, and the presence of osseousnodes, although these are rather rare. We should discourage the use of anti-syphilitic remedies for diagnostic purposes, both from the fact above men-tioned, that they may cause embarrassment to the patient, and also becausethe employment of such measures tends to make one lax in physical diagnosis.The treatment of syphilitic joint lesions is practically solved when once thediagnosis is made. The dogma of Dr. Henry J. Bigelow that the great object ofsurgery is the avoidance of operations will be fulfilled, certainly in syphiliticcases, when we have perfected our diagnosis sufficiently to enable us to recognizethe joint lesions as they present themselves. 544 AMERICAN PRACTICE OF SURGERY. Broken-down gummata should, of course, be opened.

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