If a man has appendicitis he goes to a reputable surgeon, receives an opinion, and has his appendix removed. If he consult a dozen surgeons he will get about the same advice from them all. If he has a tuberculous joint or a joint that is thought to be tuberculous, what a predicament is he in? One surgeon would put him to bed, another would immobilize the joint, another would administer tuberculin, another static electricity, another would open, scrape and pack, another would resect, and another would amputate. Some inject iodo-form, some formaldehyd solution, some charcoal, some phenol (carbolic acid), some use passive congestion, some would apply a brace, some plaster of Paris.
This is chaos. It is high time that the treatment of adult joint tuberculosis rested on a more stable foundation than empiricism, and I propose to submit three rules for the treatment, which rest, not alone on
ELY LW. THE THREE RULES OF TREATMENT IN ADULT JOINT TUBERCULOSIS. JAMA. 1912;LVIII(8):534–537. doi:10.1001/jama.1912.04260020218002
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