Diagnosis

Charles Lowell had a difficult case that came to be interpreted in a number of different ways. The immense amount of speculation made it very difficult to ascertain the correct diagnosis. Lowell consulted numerous physicians in a lifelong quest for relief. The table below details the interpretation and treatment approach of six physicians who cared for Lowell or who consulted on his case.

DOCTOR	DIAGNOSIS	REASONING	TREATMENT
Dr. Faxon	Dislocation	It made sense based on the angle and positioning of the limb.	He tried to manually reduce it before sending for Dr. Hawkes.
Dr. Hawkes	Dislocation accompanied by a fracture of the acetabulum	He agreed with Dr. Faxon given the distortment of the leg and Lowell’s limited mobility.	Attempted to manipulate the bone into place (he believed that the reduction was successful) and instructed the patient to remain in bed for 3-4 weeks.
Dr. Warren	Backward and downward dislocation into the ischiatic notch	The left leg was lengthened implying a downward trend. Based on the angle of the leg, Warren could see how it might have shifted forwards into the foramen ovale, but he also believed that the position could be affected by the nature of the accident, and therefore there was no reason it could not have shifted backwards into the lesser ischiatic notch. He felt something hard and round behind the acetabulum, and no depression where the head of the bone could have been lodged.	He gave in to Lowell’s insistence and attempted a reduction using rigged weights and pulleys according to Sir Astley Cooper’s guidelines and descriptions.
Dr. Brown	Simple luxation (dislocation)	The left leg was permanently flexed and turned out.	He did not treat the patient (Brown was asked to examine Lowell to provide medical evidence for his case against Faxon and Hawkes), but confirmed that pulleys are absolutely necessary in this circumstance.
Dr. Estabrook	dislocation	One leg was longer than the other in addition to resting at a strange angle.	Estabrook also did not treat the patient, but concurred with Brown about the method he would have selected.
Dr. Smith	Fracture; no dislocation	Smith could not be sure that there was ever a dislocation. A twist of the pelvis could explain the elongation of the left leg.	Smith was only called in to do an assessment so that the defense could use his testimony in court.