The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . sis is seen to followexsection of the hip-joint with especial frequency. Upon this circum-stance is based the statistically proved fact that the expectant or rathernon-operative treatment of this complaint yields better results than anactive operative therapy. Note.—These facts find a ready explanation in the circumstances under which most earlyexsections of the hip-joint are carried out. The depth of the diseased joint; the diflSculty ofliberating the head of the femur, sti
The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . sis is seen to followexsection of the hip-joint with especial frequency. Upon this circum-stance is based the statistically proved fact that the expectant or rathernon-operative treatment of this complaint yields better results than anactive operative therapy. Note.—These facts find a ready explanation in the circumstances under which most earlyexsections of the hip-joint are carried out. The depth of the diseased joint; the diflSculty ofliberating the head of the femur, still held down firmly by undestroyed ligaments; the desire ofoperating subperiosteally, that is, with the employment of a good deal of blunt force; the forci-ble manipulations in distending the edges of the deep wound by retractors—all serve to propelany freed caseous matter into the cut orifices of veins and lymphatics. The result is that, bythe time the local tuberculosis combated by the surgeon is healed, the patient succumbs tomeningeal or pulmonary tuberculosis, probably chargeable to operative Fig. 196.—Giant cell containing one bacillus from Ylg. 191(700 diameters). (Koch.) TREATMENT OF TUBERCULOSIS. 267 II. COMPLICATION OF TUBERCULOSIS WITH PYOGENIC ORSUPPURATIVE INFECTION. Tubercular decay of tissues by caseation is a generally slow process, aslong as the aifection remains subcutaneous—that is, occluded from accessof air with its pyogenic organisms. But let a tubercular focus of the lungperforate into a bronchus, or let a group of caseous glands, or a cold abscesscommunicating with a distant focus of the spine or some joint, be openedwithout aseptic precautions, and the affection will have at once enteredupon a new and more destructive phase. The formerly thin, flocculent dis-charge will assume a more purulent character, the production of pus willbecome prodigious, more or less fever will set in, and the symptoms of arapidly progressive local destr
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