On coxalgia, or hip disease / by Alden March.

  • March, Alden, 1795-1869.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: On coxalgia, or hip disease / by Alden March. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    The ilio-femoral ligament is accessory to the capsular, and extends from the anterior inferior spinous process of the ilium to the anterior inter-trochantral line, by which the capsular ligament is greatly strengthened in that direction. The ligamentum teres is attached by a round apex to the depres- sion just below the middle of the head of the femur, and by its base into the borders of the notch of the acetabulum: It is covered by the synovial membrane. The transverse ligament is continuous with the cotyloid, extending from one point of the notch to the other, completing the circle of the cotyloid ligament, and converting the notch into a foramen, through which the bloodvessels enter to supply the interior of the joint. The synovial membrane is quite extensive, lining the capsular ligament, the free surface of the cotyloid, the ligamentum teres, and the cartilages of the head of the bone. The muscles about the hip-joint, the active agents in producing distortion, are the flexors, adductors, and rotators. I believe all authors describe two principal forms of morbus cox- arius, or hip disease; one, in which the inflammation commences in the cartilage; and the other, when the cancellous structure of the bone is the primary seat of the affection. In either case, the result may involve all parts of the joint, and prove equally destructive. That form of it in which the cartilage is the first part attacked, is not unfrequently met with in adults ; whereas the scrofulous form, the other variety, is mostly confined to children, and persons under the age of puberty. The hip-joint may be subject to other forms or varieties of disease : rheumatic inflammation, interstitial absorption, porcelaneous deposit, etc. But it is believed that the changes of structure consequent upon these affections do not often simulate or counterfeit the symp- toms of dislocation. I shall, therefore, confine my remarks mostly to the subject of ulcerative absorption, by which such changes have resulted in the articulation as have too often been called dislocation. I presume it will hardly be denied that surgical authors, and even the most experienced practical men, support the doctrine of spon- taneous luxation of the head of the os femoris as a result of hip disease. And yet, to prove this point, it is deemed important to make brief extracts and quotations from such surgical works as are contained in my own library, which are all of modern date, as well as to refer to those of a more remote period.