Book Description

Excerpt from The Chicago Medical Recorder: January 1912 Diagnosis and Symptomatology. Many of us have to be struck a very direct and decided blow to be awakened to the fact that our patient has a fracture. If we rest too contentedly on the assumption that fractures are obvious, we can hardly be supposed to possess any more surgical skill than is the attribute of the ordinary policeman, and all of our supposed training and experience goes for naught. If, for instance, we wait until a limb is lying at right angles to the plane of the body before we decide that the bone is broken, or if we search first and last of all for crepitus, and confine our efforts at diagnosis to pulling a patient's leg around for crepitus until he yells loud enough to waken the dead before we decide that he has a fracture, we are only doing what the man on the street could do, without bring ing the poor fellow to' an institution where he ought to be able to get a great measure of scientific diagnosis without having to pay such a heavy price for it. We should learn to cultivate the finer methods of diagnosis, since these are quite as accurate and can, in the great majority of cases, be carried out without either pain or injury to the patient. These methods are based on an intelligent study of the natural history of fractures, and are classical. Firstly, if we find m the limb a false point of motion - that is, motion which is not by any possibility a result of joint action - this false point of motion once established shows beyond the peradventure of a doubt the existence of a fracture. Where a limb is badly injured and not only the bone broken but supporting soft parts crushed, this false motion point requires no close investigation. But where the bone is the only structure injured and even that may show merely a fine line of separation and but a trifle of false movement, the case may call for close diagnosis. Secondly, deformity, if it is acute and capable of being proved not to have heretofore existed, should make one strongly suspicious of the existence of fracture; although where either deformity or a suspected false point of motion develop around joints we have to exclude not only the various forms of dislocation, but in young per sons we have to be awake to the possibilities of that form of fracture known as epiphyseal separation. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.