The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . suppuration, whichgives rise to caries and limited necrosis(Fig. 436 a); as the diseased action ap-proaches the articular surface, the in-crusting cartilage becomes loosenedand detached, and at the same timegradually disintegrates, and becomesperlbrated (Fig. 486 6), nutrition in itbeing arrested or modified by the mor-bid state of the subjacent bone. Whenonce the cartilage becomes affected, thewhole of the interior of the joint speed-ily suppurates, and is destroyed. Inother cases, inflammatory
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . suppuration, whichgives rise to caries and limited necrosis(Fig. 436 a); as the diseased action ap-proaches the articular surface, the in-crusting cartilage becomes loosenedand detached, and at the same timegradually disintegrates, and becomesperlbrated (Fig. 486 6), nutrition in itbeing arrested or modified by the mor-bid state of the subjacent bone. Whenonce the cartilage becomes affected, thewhole of the interior of the joint speed-ily suppurates, and is destroyed. Inother cases, inflammatory congestion, Kg. , Caries of Head of Tibia. but without the formation of tuberCU- &, Perforation of 220 DISEASES OF JOINTS. loiis matter, takes place in the articular ends, vvliich become somewhatexpanded; and tlien, without an} suppuration occurring in the osseousstructure, tlie cartilage gradually separates or peels off, and becomessoftened and necrosed. This condition is often met with in disease ofthe tarsal articulations. Arthritis commonly results from wounds of joints or injuries^ aimh assprains and fractures occuriing in their vicinity, more particularly inyoung people and in those of a lymphatic constitution. It also occursas a not unfrequent accompaniment of pyaemia (Vol. I. pi). 699, 709),and of some of the morbid conditions of ihe puerperal state. The puer-peral inflammation of joints is of a very destructive character, mostgenerally speedily terminating in suppurative disorganisation. One orseveral joints may be affected, and the knee is the one that is most fre-quently and seriously involved. Puerperal arthritis probably dependsupon a purulent infection of the blood, t
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