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Cases of tuberculous dropsy of the joint should, as soon as diagnosis is possible, be operated upon, as all other means will have little effect. This operation generally consists in making incisions into the joint, removing the swelled synovialis. After having washed out the joint with disinfecting fluid, dust it over with iodoform, put in drainage-tubes, etc. The idea of preventing the spread of tuberculosis from an affected joint is less an indication for operative measures than the local condition itself. Such measures, amputation especially, may sometimes be called for to cut off the dangers of septicæmia, pyæmia and amyloid degeneration of the kidney and other organs; it is indeed surprising to see the rapid general improvement of the patient following amputation. Where we are certain of a large osteal focus or some partial destruction of the joint, we are not necessarily compelled to make a
STAMM M. TUBERCULOSIS OF BONES AND JOINTS. Read before the Northwestern Ohio Medical Association, at Lima, Ohio, December 9, 1886. JAMA. 1887;VIII(11):285–288. doi:10.1001/jama.1887.02391360005001a
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