SURGICAL COMPLICATIONS AND SEQUELS OF FEVERS. 7 



served, is, therefore, ver^- marked. Usually they were single 

 dislocations, 6 being on the right side and 6 on the left ; but in 

 3 cases dislocation of both hips occurred. 



From the apathetic condition of the patient in some cases, 

 the subacute nature of the lesion, the absence or slightness of 

 the pain, the masking of the swelling by even the wasted mus- 

 cles about the joint, and, above all, the want of knowledge of 

 cause or probability of the dislocation, and therefore the neglect 

 to examine the parts thoroughly, it is not surprising that this 

 threatening evil should have been often unobserved. In 9, that 

 is, one-third of the cases, it is distinctly stated that the actual 

 dislocation was the first fact observed, and in most of the others 

 this is probabl}"" true. 



The date at which the dislocation was, at least, observed, was 

 generally after the third week. One case occurred in the first 

 week, 4 in the second, and 9 in the fourth week or later, that 

 is, during distinct convalescence. Pain was experienced in 13 

 cases. Usually, it was not severe, nor was it always strictly 

 localized in the hip, but sometimes extended to the entire leg. 

 In only 2 cases was it referred to the knee, thus differing 

 markedly from the well-known coxalgic knee-pain. Swelling 

 is only distinctly stated in 6 cases, though probably present 

 here as in other joints, but either unobserved or often unre- 

 corded in the brief statements I have often found. The variety 

 of the dislocation is not named in 10, but as in all the other IT 

 it was iliac, there is good reason to believe that this is probably 

 always the case. Shortening is recorded in 11 cases, and where 

 the amount is named was generally one and a-half to two 

 inches. In 5 cases the rotation was inward, in 2 outward, and 

 in 2 of the 3 double dislocations both legs were rotated in the 

 same direction, that is, right or left, thus producing a peculiar 

 deformity when compared with the apparently reversely rotated 

 body. The head of the bone in 4 cases was freelj^ movable in all 

 directions. This mobility of the head and the singular diver- 



