The etiology, pathology, and treatment of diseases of the hip joint / by Robert W. Lovett.

  • Lovett, Robert W. (Robert Williamson), 1859-1924.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The etiology, pathology, and treatment of diseases of the hip joint / by Robert W. Lovett. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    congestion, venous stasis, and rapid disintegration Moreover, it is easy to see, as ]\Ir. Neve * explains, why external causes tend to locate disease of the bone in this region. When a child is exposed to a sudden jar or a traumatism of any sort, much of the force will be transmitted to the cartilage and modified by its elasticity. But the maximum effect of the injury will be manifested, for mechanical reasons, at the junction of the rigid bone and yielding cartilage. [Moreover, the fine capillary network above alluded to will act as a filter for infectious material and pathogenic or- ganisms. For these reasons infection and traumatism in predisposed subjects favor a juxta-epiphyseal location of the disease, and this explanation serves equally well to explain why chronic articular ostitis is located so often in the same region. The first stage of the process is an increased hypersemia of the vessels in the neighborhood of the epiphyseal cartilage. Stasis and cellular infiltration follow, and with the distention of the vessels the nutritive supply is cut off over large or small areas, because swelling is impossible on account of the rigid cortical layer, and strangulation follows, causing the necrosis of larger or smaller areas of spongy tissue. An acute purulent inflammation being present under such conditions, the destruction of bone is rapid. Melted down by the pus or shut off from its blood supply, it disintegrates, and the process extends, most often in the direction of the joint. At an early stage the naked eye sees on section an area of spongy tissue of considerable extent, which is bright red or dusky; and the marrow is transformed into a semi-fluid mass of pus and melted fat, often offensive in odor, colored more or less red b}' extravasated blood. The periosteum is generally thickened, and purulent periostitis may be present secondarily. The cancellous tissue is pink and somewhat thickened. If the detritus is washed away, the spongy tissue ♦Arthur Xeve, Practitioner, January, iSgi.