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July 1921


Arch Surg. 1921;3(1):181-229. doi:10.1001/archsurg.1921.01110070194011

TUBERCULOSIS  Tuberculous Rheumatism.—Duvernay1 states that while the existence of the tuberculous rheumatism of Poncet is generally recognized, there are many erroneous conceptions concerning its pathology and treatment. He believes that the joint symptoms represent an antitoxic or reactional phenomenon, and that there is no evidence to suggest the presence of the Koch bacillus in the joints affected. When the toxic substances are abundant, tuberculous rheumatism seldom appears. He considers it a symptom of convalescence when the organism is defending itself and the antibodies are very abundant. This conception has important bearing on rational treatment, and Duvernay's recommendations are that the local therapy should be the therapy of any nontuberculous arthritis, viz., warmth and immobilization in the acute stage, but mobilization and massage as early as possible to avoid atrophy and ankylosis.[Ed. Note.—Our experience with true tuberculous rheumatism has been slight, but in certain rather typical and apparently

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