Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value . Fig. 6. Tuberculous sinus originating in the sacrum, thought to be an abscessof hip. examples which illustrate most lucidly that faulty diag-nosis was responsible for the failure in treatment, andthat in most of the cases a cure was obtained as soon asthe correct diagnosis was made. DIAGNOSTIC! KKIiOKS KKVKALKD. ?>1 Example 1. Osteomyelitis of Femur Treated for Hip Joint Disease.—Mr. C, aged 26, farmer, gives the following history: at the age of23 he developed a large abscess about his hip. An incision
Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value . Fig. 6. Tuberculous sinus originating in the sacrum, thought to be an abscessof hip. examples which illustrate most lucidly that faulty diag-nosis was responsible for the failure in treatment, andthat in most of the cases a cure was obtained as soon asthe correct diagnosis was made. DIAGNOSTIC! KKIiOKS KKVKALKD. ?>1 Example 1. Osteomyelitis of Femur Treated for Hip Joint Disease.—Mr. C, aged 26, farmer, gives the following history: at the age of23 he developed a large abscess about his hip. An incision and drain-age left a discharging sinus. A year later an operation for hip jointdisease was performed, which failed to produce a cure. Later the areaof suppuration was increased, so that four sinuses resulted. Thesesinuses were repeatedly curetted, but without avail. The radiograph. Fig. 7. Bismuth paste remaining in focus of disease four months after clo-sure. Hip shown to be normal. (Case shown in Fig. 6.) (Fig. 5), taken after injection of the paste for diagnostic purpose, re-vealed the fact that the hip joint was not affected at all, but that itwas the shaft of the femur which was the original source of infection,and that at this source there was also a sequestrum, the removal ofwhich produced a closure of three sinuses within a month. The fourthsinus kept on discharging some serous fluid, but otherwise caused noinconvenience. Patient gained forty-five pounds after the suppurationhad ceased. 38 BISMUTH PASTE IN CHRONIC SUPPURATIONS. It is not surprising that this mistake in diagnosis wasmade by a number of competent physicians, becausethere existed severe lameness, and even some shorteningof the affected limb, but our radiograph shows distinctlythat the head of the femur and the acetabulum are in-tact, and no connection existed between the large abscesscavity
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