Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

The patient does not appear worn as one whose joint is ulceratr ing. So is the position of the patient and limb peculiar and well worthy of remark. When we see her at rest as she chooses, we find her lying slightly over towards the affected side, and the sick limb is averted so as to lie on its outer side, with the knee semi-flexed and some swollen. If we attempt to apply our hand to the knee, the girl will shrink and express suffering before the limb is even touched; and if we do touch it, or attempt to move it, she will plead or shriek and resist it instantly and most earnestly. Even the merest approximation of the hand intimat- ing the slightest indication of a manipulative examination, is met by the instantaneous extension of both her hands, and her whole attitude and expression are those of intense fear with re- sistance. Such is a hysterical joint, and such cases are by no means rare. (See Appendix F, G.) Miss S., aged about thirty, was very sick before ten years of age, with severe cutaneous disease and fever, after which she began to feel at times a " stiffness " in the left hip joint, which was more marked from thirteen to fifteen, while at boarding school. She suffered great pain about that hip at menstrual times, and often for whole months together, when she became confined to her lied, and retained the limb in a semi-flexed posi- tion for long periods. She had had various and the best of medical advice and treatments for the last twenty years. When I saw her lying in bed, she was inclined somewhat over towards the affected hip, the limb drawn up, with the knee resting on a pillow, and the leg contracted upon the thigh. By measure- ment, (which was done only after most cautious, repeated, and deliberate manipulation of the ankle first, then gliding the hands along up to the knee, and while the fingers of one hand were carefully searching the contracted tendons back of the bend of the knee, and at the same time closely catechising the patient as regards sensations there, the other hand was glided over the hitherto touch-me-not hip joint, and before she was aware of it my fingers were deeply pressed, exploring the sound, deep-lying muscles about the long-fixed pseudo-anchylosed joint,) — I say that by actual measurement, it was found that the