John Scott on the treatment of diseases of the joints, and of ulcers and chronic inflammation : a new edition, with an introduction and a chapter on the constitutional origin and treatment of diseases of the joints / by William Henry Smith.

  • Scott, John, 1798-1846.
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: John Scott on the treatment of diseases of the joints, and of ulcers and chronic inflammation : a new edition, with an introduction and a chapter on the constitutional origin and treatment of diseases of the joints / by William Henry Smith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    general without any pain, except on motion, and are attended with little constitutional excitement. Before suppuration has taken place within the cavity of the joint, abscesses generally form in various parts of the cellular membrane, communi- cating with the surface of the hone. When the disease has arrived at this stage, it not unfrequently assumes a more aggravated form. Ulceration proceeds with comparative rapidity, attended with more considerable pain, and suppura- tion is established in the cavity of the articulation. When ulceration and suppuration are about to take place, the dis- order of the general health becomes more considerable than it has been during the former periods of the disease. Not that there is now any violent constitutional disturbance; but a dry feverish heat is felt on the surface of the body; the powers of the stomach are impaired ; great disinclination is felt both to take food and exercise; the appetite is often depraved, as well as defective ; the bowels are generally cos- tive ; and the patient becomes weak, languid, and emaciated. If the position of the limb be not particularly attended to, it will frequently become contracted, and in some cases this will increase until it becomes fixed at a right angle with the thigh. In other instances, the leg will be even dislocated upward and backward by its powerful flexors, so that the condyles of the os femoris form a considerable projection beyond it. When the disease has arrived at the latter stages, the patient is very much distressed by spasmodic contractions of the muscles on the affected limb, when he loses control over them in falling asleep ; the pain is also more severe at night. When the constitution is highly disposed to scrofula, or when, this disposition existing in a minor degree, its powers have been reduced by j)revious disease j it frequently occurs, that a sufficient proportion of phosphate of lime is not depo- sited in the bones to enable them to bear the superincumbent weight, and to resist the action of the muscles inserted into them. This state is more frequently manifested in the spongy extremities of the bones than in their more compact structure. Although the soft parts of the body may be imperfectly developed, and nourished in an inadequate degree without