Morbus Coxarius / by Lewis A. Sayre.

  • Sayre, Lewis A. (Lewis Albert), 1820-1900.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: Morbus Coxarius / by Lewis A. Sayre. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    OBJECTIONS TO THE TREATMENT OF MORBUS COXARIUS IN ITS ADVANCED STAGES BY EXTENSION, UNLESS PRE- CEDED BY TENOTOMY. ILLUSTRATED WITH CASES AND ILLUSTRATIONS. By LEWIS A. SAYRE, M.D., SURGEON TO THE BELLEVUE HOSPITAL. Reprinted from the American Medical Times, May 9f 1863. Since the publication of my report on morbus coxarius to the American Medical Association, in June, 1860, the treat- ment of this disease by extension has become almost uni- versal, and the plan of treatment suggested in the Report has been partially adopted, not only in all parts of this country but also in Europe. On page 23 of my Report, when speaking of muscular contraction, I state—“But this constant muscular contrac- tion exhausts the nervous system and induces hectic fever, gives the child nocturnal spasms of intense agony, caused by pressure of the head of the femur against the acetabu- lum, and produces absorption of both bones, and prevents nutrition of the limb, which results in atrophy. I, there- fore, resort to artificial means*to produce this rest and remove the pressure, and formerly divided the firmly con- tracted muscles to prevent the head of the bone from being pressed against the acetabulum, and kept them at rest in the horizontal position in the ‘ wire breeches’ of Dr. Bauer; but now accomplish the same result by gradual but permanent extension by the means of the instrument I have devised, with very much more satisfactory results, and without any danger of anchylosis, or by a weight and pulley as suggested by Sir Benjamin Brodie.”* A more extensive experience has satisfied me that in the advanced periods of the disease we cannot succeed without tenotomy, and as I am partially responsible for the present almost universal treatment by extension, it is due to myself as well as to the profession that I should clearly explain my views in regard to its therapeutical effects. The object of extension in the inflammation of all joints * Chelius’ Surgery, edited by South, American reprint, page 296—also page 300.