OUR FRAGILE SKELETONS.

Auckland Star, Volume LIV, Issue 47, 24 February 1923, Page 17

OUR FRAGILE SKELETONS.

I * <By QUACK.), Tor the past five or six years I have witnessed with growing surprise the great and increasing number of failures in bone surgery, and the astonishing efforts which had to be made by surgeons to produce satisfactory results in Aβ treatment of simple fractures.. The fracture of a long bone, away from a joint, was, years ago, considered of very small consequence: It was roughly set, with almost "any old thing" for a splint, and mostly "left to nature." The taking down of splints; massage; screws; plates; the conversion of a simple into a compound injury for curative purposes; all now quite common, were, in my early days, unknown or unuflual. The doctor's duty (the "bone setter" was often employed successfully) was merely to fix the broken ends in places, and ascertain from time to time that the splints applied were tight enough and not too tight. From three to six weeks of immobility and rest, and there the matter ended. Within the last few weeks I have met with three cases of simple fractures of the long bones of the leg, between knee and foot, the accidents dating back to the football season, and in each case there is a history of retarded recovery, Le., delayed onion. (1) Sixteen weeks in hospital: Result, weakness anl everted foot, causing lameness. (2) Ten weeks in hospital: Result, distortion of limb. (3) Bones set in box splint before reaching hospital; splints removed for examination; failure to ro-set successfully; non-union; removal to another hospital; operation; disease of bone following; second operation; result, weakened and distorted limb. In cases resulting from war injury unusual difficulties and untoward aftereffects were to be expected. Splintered bone, eeptio infection, foreign bodies, hasty field treatment, delay, unavoidable neglect, all had to be considered, bat sturdy, healthy boys sustaining simple fractures when at play, should not, normally, demand numerous surgical expedients, and prolonged attendance, and even then not show restoration to full and natural use of limbs. Pathologists, dietitians, Burgeons, sur-geon-dentists, have been unwearying in proving to us that dental decay is the result of incorrect feeding. That the substance of the teeth lacks mineral salts, which have been thoughtlessly excluded from our food. That the enamel of the teeth is attacked by lactic or other acid produced by dietetic errors, but nobody, I think, has compared the analysis of human bone as it Is today with the analysis of ancient skeletons. Iβ it not possible that the very mistakes which are rapidly destroying the teeth of our people may have also had some effect, in the direction of deterioration) upon the whole bony structure of the body? Those who have seen the bleached skeletons of men and animals side by side upon the desert, can tell you that there is a difference in colour and in texture between them, and the superficial difference probably indicates a difference in composition which we are for ever accentuating by our mode of life and our foods.

It is not easy to detect just how much of the repairing material (callus) produced at the injured extremities of the fractured bone, is thrown out by the bone, its centre, and its covering, and how much by the lymphatics, bloodvessels, and the surrounding tissues; but apart from mechanical causes of non-union, or delayed union, "general bone disease," and "general weakness or debility," are usually given as the causes of unnatural delay in process of repair. Should the bone itself be deficient in vitality it seems to mc that all forms of non-union (other than those produced by mechanical causes) owe something to that fact, and if the blood stream lacks the material to encourage or produce ossification the cause is not unconnected with the combination of physical conditions which permit our teeth to melt out of our jaws, and lead us to bite with gold, silver, platinum, cement, composition, and vulcanite, so wonderfully adapted to take the place of the natural masticators we had ignorantly destroyed. ' There is no doubt that aurgeons will soon be able to supply metallic or other substitutes for diseased bones which have been partly or wholly removed by operation, provided that the natural bones, with which the hollow jjold or [Other artificial bones connect or form a joint, do not rebel into some "itis" as the soft tissues sometimes do above a silver plate. In imitation of the physician who said that a surgeon famed for his operations on the bowels was "a very clever plumber," we may say that the surgeon who, with wire, and screws, and pegs, and plates, and dovetailing, secures the continuity of bones is "a very skilful carpenter," but just as the bowel is better unplumbered, so is a bone better uncarpentered, and if a diet of wholemeal bread and kitchen garden vitamines will (say, in a generation) restore our fragile skeleton* to substantiality, we ought to be told, and start the new regimen immediately.

It Is no wild and fanclrul suggestion to couple the teeth and their defects with the other bones of the body, for although "specialists" may make it appear that the various organs are disconnected, and that one can be medically treated without affecting all, it is a fact that the tip of every finger and toe shares in the general welfare or otherwise of the whole body, and although a food or a drug may have a definite action upon one part of it there is also an action, perhaps less definite, upon every part. lam entirely ignorant (please do not put a full stop there) if investigation of available statistics shows that general bone defects have increased pari passu with caries of the teeth, but it is more than probable. The thought that one's whole framework is not "heart of kauri" is more serious than that the teeth are goinfr, or gone; chiefly because the dentist so artfully conceals the truth that a tooth extracted is an actual mutilation —accomplished necessarily though it may be—and, by usage, we make light of it.

It is possible to obtain a knowledge of- the precise mineral constituents of hone of any ages, for four thousand years, and the records of any great hospital will show the increases (if any) in general bone disease and defects of repair over a period of years, and the question herein raised can be easily answered.

The ignorant layman quickly blamee the unhappy surgeon, who, however, is not always responsible for non-union in cases due to mechanical causes. The bone of the upper arm is particularly difficult to fix securely, and a restless child will wriggle loose from almost any splinting. Lastly, the advocates of early manage have much to answer for.