A REVIEW OF TWO HUNDRED AND ONE CASES OF SUPPURATIVE ARTHRITIS

¹ PITTSBURGH, PENNSYLVANIA

1. In the author's experience the Willems method of treatment of acute suppurative arthritis gives entirely satisfactory results when instituted at, or very soon after, onset.

2. Results become progressively less satisfactory in proportion to the length of time after onset at which treatment is started. This is believed to be the result of several factors:

(a) When sufficient time has elapsed for adhesions to develop, the pockets thus formed cannot be drained properly by the active movements. Indeed, it is possible, that this may be actually harmful in promoting absorption from such pockets.

(b) In cases of long standing, erosion of cartilage with denuded bone areas hinder or prevent efficient active movements.

(c) In cases of long duration, blood-stream infection is an everpresent danger, as well as an aggravation of existing organic diseases by the infectious process.

With these older cases some more radical procedure is obviously necessary.

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