[Illustration: FIG. 161.--Arthritis Deformans affecting several
Joints, in a boy aet. 10.
(Dr. Dickson's case.)]
_Treatment._--Treatment is for the most part limited to the relief of
symptoms. On no account should the affected joints be kept at rest by
means of splints or other apparatus. Active movements and exercises of
all kinds are to be persevered with. When pain is a prominent feature,
it may be relieved either by douches of iodine and hot water (tincture
of iodine 1 oz. to the quart), or by the application of lint saturated
with a lotion made up of chloral hydrate, gr. v, glycerin [dram]j, water
[ounce]j, and covered with oil-silk. Strain and over-use of the joint
and sudden changes of temperature are to be avoided. The induction of
hyperaemia by means of massage, the elastic bandage, and hot-air baths is
often of service. Operative interference is indicated when the disease
is of a severe type, when it is mon-articular, and when the general
condition of the patient is otherwise favourable. Excision has been
practised with success in the hip, knee, elbow, and temporo-mandibular
joints. Limitation of movement and locking at the hip-joint when due to
new bone round the edge of the acetabulum may be greatly relieved by
removal of the bone--a procedure known as _cheilotomy_. Loose bodies and
hypertrophied fringes if causing symptoms may also be removed by
operation.
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