Patients with tuberculosis of the joints often die of miliary tuberculosis, the most serious form of which is tuberculous meningitis. This is a problem that has long been troublesome to those who treat tuberculosis of the joints. Regardless of whether the patient is treated by conservative or by radical procedures, there is a certain mortality due to tuberculous meningitis. It is important, therefore, to attempt to determine which of the two phases of treatment of tuberculous joints allows the lowest mortality so far as tuberculous meningitis is concerned.
The records of the New York Orthopaedic Dispensary and Hospital lend themselves ideally to such a study because both the conservative and the radical treatment of tuberculosis of the joints have been given long trials at this institution.
For over forty years, or from the founding of the hospital in 1866 until 1911, tuberculosis of the joints was treated conservatively. A country