Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value . an abscess in his hip. One year later hisphysician incised and drained the abscess, and purulent discharge con-tinued for two years. In April, 1908, I made the first injection ofbismuth paste, whereupon the sinus closed. With the aid of a highshoe the boy could now run about as well as his healthy comrades,and was well until September, 1909 (sixteen months after closure), COLD ABSCKSSKS. ] when he fell downstairs, which accident was followed by chills andfever of 103°, and extreme tenderness of the hip. Fo
Bismuth paste in chronic suppurations, its diagnostic importance and therapeutic value . an abscess in his hip. One year later hisphysician incised and drained the abscess, and purulent discharge con-tinued for two years. In April, 1908, I made the first injection ofbismuth paste, whereupon the sinus closed. With the aid of a highshoe the boy could now run about as well as his healthy comrades,and was well until September, 1909 (sixteen months after closure), COLD ABSCKSSKS. ] when he fell downstairs, which accident was followed by chills andfever of 103°, and extreme tenderness of the hip. For three weeks hiship was treated with liniments, etc., without any relief, and a largeabscess in the gluteal region appeared. In this condition he was againbrought to me for treatment. On October 24, 1909, the prophylacticmethod of bismuth treatment was carried out as follows: An incision two inches long was made through the gluteal muscles,reaching a deep abscess. The pus was allowed to escape without anyscooping or the introduction of gauze, and the resulting cavity was. Fig. 64. Patient whose pelvis is shown in Fig. 62, standing on the diseasedlimb two weeks after injection of abscess. filled with a 10-percent bismuth paste. The radiograph (Fig. 62) illus-trates the size and shape of the cavity. The shadow of a buckshotrepresents the location of the opening of the sinus. This radiographalso illustrates the extreme tilting of the pelvis and the atrophy ofthe shaft of the femur, which occurs in some of the cases of hip jointdisease. For comparison I show a radiograph (Fig. 63) of a normalpelvis of a child of the same age. Child has fully recovered and sup-ports his body weight on the tuberculous limb. (Fig. 64.) Tuberculosis of Elbow with Multiple Cold Abscesses.—L. R., aged18, when 8 years old was operated upon for tuberculosis of the knee 164 BISMUTH PASTE IN CHRONIC SUPPURATIONS. joint. Result, primary union, with considerable shortening. Sincethen the patient remained a
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