Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright.

  • Wright, G. A. (George Arthur), 1851-
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Hip disease in childhood : with special reference to its treatment by excision / by G. A. Wright. 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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    tubercular. Bryant believes the disease to be local, and in children usually an articular ostitis. Erichsen, in his work on Surgery, p. 451, vol. ii., edit, viii., describes the post mortem appearances of the hip in a child of eight, who died of pneumonia six weeks after the onset of hip disease. The joint contained pus; the ligamentum teres was softened and coated with lymph; the synovial membrane inflamed; a yellow, dense, hard patch of bone occupying parts of both the epiphysis and diaphysis was found on section of the femur; hard tubercular spots lay in the cancelli; the deep surface of the cartilage was eroded, and the synovial membrane destroyed where it came into contact with the diseased bone. This I take to be a typical example of the common form of hip disease, except that perhaps the tubercles were more than ordi- narily abundant and well marked. In another case there was one tubercular focus in the acetabulum, another at the epiphysial line of the femur. Ford, in i8iO,*described it as a white swelling, beginning in the bone or cartilage and not differing from other joints. Bonnet,f whose treatise is as interesting and in many ways valuable as it is elaborate, does not discuss very fully this point, but seems to decide from the analogy of other joints that the mischief begins in the synovial membrane. Brodiet describes a synovitis, now sometimes called by his name, or more often perhaps pulpy or gelatinous degeneration, corresponding to the tumeur fongeuse of Bonnet. He (Brodie) also cites cases of acute synovitis, and believes that there may be a primary ulceration or absorption of cartilage by means of its own vessels, the process beginning on the free surface, as well as by extension from both bone and synovial membrane. He also describes a fibrous change in cartilage frequently preceding ulceration, and giving rise to absorption of the cartilage, the rest of the joint structures remaining normal, except that sorae- * Observations on Diseases of the Hip. t Traitedes Maladies des Articulations. % Diseases of the Joints.