Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value . ograph (Fig. 70) of this arm showsenormous destruction of the ulna and elbow joint. The entire ulnawas practically a sequestrum, and the futility of any conservativetreatment was evident. The sequestrum was removed under anes-thesia, and its natural size and colors are shown in the colored cavity was packed with gauze, and the next day was filled with bis-muth paste. The abscesses on the left arm were incised and injected,and closed without secondary infection within three days. Temperature 176 B
Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value . ograph (Fig. 70) of this arm showsenormous destruction of the ulna and elbow joint. The entire ulnawas practically a sequestrum, and the futility of any conservativetreatment was evident. The sequestrum was removed under anes-thesia, and its natural size and colors are shown in the colored cavity was packed with gauze, and the next day was filled with bis-muth paste. The abscesses on the left arm were incised and injected,and closed without secondary infection within three days. Temperature 176 BISMUTH PASTE IN CHRONIC SUPPURATIONS. ceased after first injection. The healing progressed rapidly, and threeweeks after the operation the wound was practically closed, the boyhad gained twelve pounds, and had practically normal motion in botharms. (Fig. 71.) It must, however, be stated that he had at the sametime received antiluetic treatment, which may, to a certain degree,account for the rapid improvement, although the same treatment be-fore the operation did not have this Fig. 71. Complete closure three weeks after operation and bismuth of ulna from left arm. Faulty Technic. Faulty technic is, no doubt, the cause of many fail-ures. I have often been surprised to find that cases re-ferred to me, in which the paste had been used faith-fully for months without success, responded to my firstinjection and closed. The underlying principle must always be kept in mindthat the bismuth paste must be soft enough to permit itsflowing into the remotest parts of the channels and fillingevery one of them completely. In Fig. 72 we show a LIMITATIONS AND CAUSES OF FAILURE. 177 bone cavity which was injected, but not filled a small side-pocket or branch of a sinus is missed, thesuppuration will continue and in time the entire tract ofthe sinus become reinfected.
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Keywords: ., bookcentury1900, bookdecade1910, bookpublisherstlou, bookyear1910
