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to considering the question of operative treatment, cannot be overestimated. Much has been written by authorities in all parts of the world upon this subject. Nothing, to my knowledge, has appeared that is more practical and helpful to the practitioner than the papers of Drs. F'itz, Homans, Gay, M. II. Richardson, J. W. Elliot, and others in our own neighborhood. In spite of all, however, the early diagnosis is not always easy to make, at least to those who do not see large numbers of cases. Ofdoi:10.1056/nejm189303231281204 fatcat:ej3oz2sm2vdyto3mma3p6l2hzi