On the pathological basis of the treatment of joint diseases / by Henry G. Davis, M.D.

  • Davis, Henry G. (Henry Gassett), 1807-1896.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: On the pathological basis of the treatment of joint diseases / by Henry G. Davis, M.D. 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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    mosis more or less deep. On the contrary, where the cartilages are ulcerated, it is unequal, dotted. In speaking of ulceration of the cartilages, he says that it proceeds from the free surface to the adhering surface. Observation 1st.—A man, 60 years old, entered the Hotel Dieu of Lyons with oblique fracture of the middle of the femur. The limb was placed in Boyer's splint, and permanent extension made. After three months' treatment, the patient contracted diarrhoea, and died without having experienced any pain in the joint of the fractured limb. Autopsy.—The bones of the fracture are blunt and rounded, with- out the least trace of agglutination. A bundle of muscular fibres separates the ends of the bones. The soft parts are infiltrated with blood to a great extent, but do not present any sign of inflammation. The knee of the affected side contains a great quantity of effused blood. The cartilage of the internal articular fossa of the tibia, upon the posterior side, is destroyed to half its depth, in a circular form, having a diameter of one centimeter. The loss of substance is upon the free side, the depth unequal, and the circumference injected for some lines. The portion of cartilage, of the internal condyle of the femur, contiguous to the erosion, of which we have just spoken, is affected in all its thickness by a loss of substance, similar in its aspect and di- mensions. The cartilage of the external articular fossa of the tibia is ulcerated behind in an irregular space, being about two centimeters in length. The loss of substance is of little depth, and unequal; the contexture of cartilage which supports this erosion is evidently soft- ened and swollen; the other portions of the cartilage present an in- jected appearance, of a lively, uniform red. A similar redness is ob- served iu the cartilage of the external condyle of the femur, in the whole extent corresponding to this last loss of substance. The dis- eased cartilages are detached from the bones with the greatest ease, but the femur has not undergone any alteration. The tibio-tarsal joint, notwithstanding its distauce from the frac- ture, also presents an effusion of blood, a yellowish tint of the carti- lages, which are also deprived of their polish, and an injection with tumefaction of the synovial membrane, which forms a fold between the tibia and the fibula. Observation 2nd, (communicated to Bonnet by Dr. Martin.)—-A female 70 years of age, of impaired constitution, confined to the bed