In considering the surgical treatment of chronic arthritis it is of prime importance to distinguish the different types of arthritis, because I believe that a remedy which may be very beneficial in one type may be useless in another and even harmful in still another. I believe that much of the confusion and many of the failures can be traced to the lack of careful differentiation. Before the time of the discovery of the pus micro-organisms by Ogston, the tubercle bacilli by Koch and the gonococcus by Neisser this subject was in a chaotic condition, and even now much confusion exists in the minds of most medical men.
Within the limits at my disposal it is manifestly impossible to discuss in detail all the different types of chronic arthritis. I have consequently concluded to pay especial attention in these remarks to a consideration of