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ORTHOPEDIC SURGERY AND DISEASES OF THE JOINTS. 557 two or three months, the disease is evi- dently not improving, we ought to lay the joint open antiseptically and re- move as much of the pulpy degenera- tive material as possible, and drain it for two or three weeks. If, after this, it be not cured, excision should be done. If the disease is medullary, Buy Cheap Cefaclor absolute rest, at first inside a plaster case, and counter-irritation, especially with the actual cautery, should be tried ; if these prove inetfectual, he would gouge; if this is not curative, excision should be performed. ■ In a discussion that followed, Mr. Teale advocated incision of the capsule, so as to allow of the continuous escape of the fluid into the tissues outside of Cefaclor Generation it. lOi M. Cazin advocates rectal ex- amination as an aid to diagnosis in hip-joint disease. He first points out the difficulty of ascertaining the exact seat of the disease, and of determining how far the acetabulum is involved. The coxo-femoral articulation, Cefaclor 500mg on ac- count of its depth, is little accessible to examination, and from this fact rectal exploration is the readiest way to ap- proach it. On the internal surface of the pelvis, immediately above and a little behind the obturator foramen, a smooth osseous surface is met with, almost quadrilateral, which the old anatomists did not name, but which is called the inclined plane of the pelvis. The Order Cefaclor Online surface corresponds to the border of the acetabulum, and is designated the post- acetabular surface. The inner portion of Cefaclor Monohydrate the cotyloid cavity in an adult is very thin, Order Cefaclor and scmietimes trans- parent. In the child below fourteen years of age it is occu[)ied by cartilage, divided into three branches, represent- ing the form of the letter Y. This sur- face is readily Cefaclor Antibiotics accessible to the finger througii the rectum. The autlior has examined ninety-eight cases of hip- joint disease, sixty-f(;ur of which were sup- purative, and thirty-four non-suppura- tive. Abdominal examination enables us to detect enlarged glands in this re- gion, or pelvic abscess, but rectal exam- ination is more certain. Out of ninety- eight cases examined, forty-nine gave appreciable results. Tliere were thirty- Cefaclor Cost seven cases of suppurative coxalgia, and thirty-four of tlie ntm-suppurativc vari- ety. Of the latter, oidy twelve gave any result. In girls, tlie examination was made per vaginam. The Cefaclor Tablets results of these examinations have been confirmed six times by the operation of excision, four times by autopsy, and twice by excisioa^ind autopsy. Cefaclor Antibiotic The synlptoms found on rectal touch were : localized pain, revealed by press- ure on the post-cotyloid surface ; Buy Cefaclor Online the presence of engorgement of the intra- pelvic glands; increase in the Siw^ of the component parts of the acetabulurii ; depression ; destruction and perforation of the post-cotyloid surface ; swelling of the soft parts; and pelvic abscesses of various sizes. The symptom most diffi- cult to make out is pain on pressure, especially in young children. Modifi- cation in the size of the bone can be appreciated by comparison with the sound side. Thickening of the soft parts, more or less marked, more or less extended, with or without appreciable bone Cefaclor Generic lesion, ordinarily indicates sub- periosteal abscess behind the obturator internus, with or without perforation. 11. M. Terrillon advocates the use of a new apparatus to correct deformities of the thigh after disease about the hip joint. It consists of Cefaclor Ceclor a solid tube, to which are attached two curved steel bars arched over the iliac bone, and having attached to them a thin steel plate, molded to adapt themselves to the inequalities of the lateral and Cefaclor Price ante- Cefaclor Cd rior poi'tions of the ilium on either side. When api)lied, these are fixed by screws. The object Purchase Cefaclor Online of this apparatus is to fix the pelvis so that the force applied to the limb may be direct. He Cefaclor 250mg reports a Purchase Cefaclor case in which the Cefaclor Mg apparatus was used.

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