(COXALGIA.)
Hip-joint disease, also known as Coxalgia, is frequently a scrofulous affection of the hip-joint. It usually attacks children, but may occur at any period of life. The causes of this affection are imperfectly understood, yet all the indications point to a scrofulous state of the system. Dampness, cold, improper diet, severe injuries from blows or falls are all numbered among the exciting causes which are conducive to the establishment of this disease.
The Symptoms are usually developed gradually; at first there is severe pain in the knee, but finally it is located in the hip-joint. Occasionally it is noticed in the hip and knee at the same time. As the disease progresses, the general health becomes impaired, there is wasting of the muscles, wakefulness, disturbed sleep, high fever, profuse and offensive perspiration, the hair falls out, and there is an inability to move the limb without producing excruciating pain. Frequently pus will be formed and discharged at different points, and the limb will become greatly emaciated. Since pain in the knee-joint may mislead as to the location of the disease, to determine the seat of the affection, place the patient in a chair and percuss the knee lightly, by giving it a slight blow with the knuckle; if the hip be affected, the pain will be readily felt in that joint; if it be simply neuralgia of the knee-joint, it will excite no pain whatever. If the disease be allowed to progress and dislocation of the joint takes place, the affected limb becomes shortened.
Treatment. The treatment of this disease should consist in rest for the hip-joint, cleanliness of the person and plenty of fresh air and light, a nutritious diet and the use of tonics and sustaining alterative, or blood-cleansing medicines. Dr. Pierce's Golden Medical Discovery has, unaided by other medicines, cured many cases of this disease. This class of medicines should be persistently employed, in order to obtain their full effects. It is a disease which progresses slowly and which is not easily turned from its course, and its fatality should warn the afflicted to employ the best treatment.
Many poor, unfortunate victims know too well, from sad experience, that the course of treatment frequently recommended and employed by physicians and surgeons is ineffectual, and cruel; they deplete the system, apply locally liniments, lotions, iodine, and hot applications; confine the patient in bed and strap his hips down immovably, thus preventing all exercise; then they attach that cruel instrument of torture, the weight and pulley, to the diseased limb.
After many years of practical experience in the treatment of hundreds of cases, we have developed a system of treatment for this terrible malady which is based upon common sense. Instead of depleting, we, by proper constitutional treatment, strengthen and fortify the system. We do not confine the patient in bed, but permit him to go around and take all necessary exercise. We adjust an ingeniously devised and perfectly fitting appliance or apparatus, by which a gentle extension of the limb is maintained, thereby relieving the tension of the muscles, and preventing the friction and wearing of the inflamed surfaces of the joint, which, without the use of our new and improved appliance, are a source of constant irritation. The appliances required in the successful treatment of this disease are numerous and varied in their construction, and require skill and experience on the part of the surgical mechanic as well as on the part of the surgeon, to take accurate and proper measurements of the diseased limb, and to construct the appliances so that they will be adapted to the various requirements of different cases. There are no definite rules for taking these measurements, and only a thorough examination of the case can indicate to the eye of the experienced surgeon what measurements are required, and what kind of an appliance is suitable for each individual case. At the Invalids' Hotel and Surgical Institute these measurements are all taken by the surgeon in person, and each appliance is constructed under his immediate supervision. It is utterly impossible for physicians who have but a limited experience in the treatment of such cases to take correct measurements and send off for an apparatus which fulfills the requirements of the case.
In the light of our vast experience at the Invalids' Hotel and Surgical Institute, we feel that we cannot too strongly urge the employment of a suitable apparatus for supporting the hip-joint, giving it perfect rest, and enabling the patient to exercise and get the outdoor air. As much of the pain in this disease is due to the pressure of the head of the femur, or thigh-bone, in the acetabulum, or socket, steadily-applied mechanical extension, to relieve the inflamed and sensitive joint of the pressure, is of the greatest importance. By such application the patient is enabled to move about without pain, while the joint is kept perfectly at rest—a condition favorable to the reduction of inflammation within it. The surgeon specialist of the Invalids' Hotel and Surgical Institute is frequently sent for to visit cases of this disease hundreds of miles away and by the employment of suitable apparatus he has been enabled, in scores of cases, to relieve the suffering at once. In cases in which the head of the thigh bone, or the bony socket of the joint has become so diseased as to cause it to ulcerate and break down, all portions of diseased bone should be thoroughly removed by a surgical operation. If this be neglected or delayed, a fatal termination of the disease may be expected. Parents should not put off the employment of a competent specialist in this terrible, distressing, and fatal disease. As treated by general practitioners, it very often proves fatal; or, after causing intense suffering for a series of years, if the active condition of the disease subsides, the patient is left with a ruined and broken constitution, a result which more prompt and earlier relief would have prevented.
The records of practice at the Invalids' Hotel and Surgical Institute abound in reports of cases, demonstrating the fact, that by careful and judicious management, hip-joint disease in its earlier stages, may be promptly arrested, and that cures may be effected even when the bony structure of the joint is seriously diseased.
WHITE SWELLING
White Swelling, otherwise known as Hydrarthrus, or Synovitis, more frequently affects the knee-joint than any other part. The joints of the elbow, wrist, ankle, or toes, may, however, be affected with this disease, but we shall speak of it in this connection as affecting only the knee-joint. Synovitis may be acute or chronic. The latter form is sometimes induced by blows, sprains, falls, etc., or from exposure to cold; more frequently it is the result of rheumatism or scrofula.