A system of surgery . iseased. This symptom of startingis, however, not invariablypresent with all forms of de-struction of cartilage. Inosteo-aithritis it is absent,also in gout and in Charcotsdisease; and even in theacute change which accom-panies pyaemia it is not a noticeable feature in the destruction ofthe cartilage. The treataisesit of diseases of cartilage has nothing specialabout it apart from that of the disease in which it is only a singlefactor. The paOgaaosis, however, in any case where the surfaces of ajoint have been destroyed by acute or chronic inflammation, is alwaysgrave, in
A system of surgery . iseased. This symptom of startingis, however, not invariablypresent with all forms of de-struction of cartilage. Inosteo-aithritis it is absent,also in gout and in Charcotsdisease; and even in theacute change which accom-panies pyaemia it is not a noticeable feature in the destruction ofthe cartilage. The treataisesit of diseases of cartilage has nothing specialabout it apart from that of the disease in which it is only a singlefactor. The paOgaaosis, however, in any case where the surfaces of ajoint have been destroyed by acute or chronic inflammation, is alwaysgrave, in the first place often as regards the patients life, for thisindicates very serious disease, and next as regards the functions ofthe articulation. For once the cartilage is destroyed, it is notreplaced by the usual hyaline material which covers the ends ofbones, but by fibrous tissue; and as this is equally developed onboth surfaces, it forms a bond between the two, which preventsmovement. (See Anchylosis, page 1067.). Fig. 431.—Destruction of Ortilage by flask-sliaped Prolongations of Granulation Tissuefrom below. (From a Photograph by ) JOINT DISEASE COMMENCING IN THE BONES. In the article on Diseases op Bone (page 873) will be con-sidered the details of the various morbid processes found in the DISEASE COMMENCING IN BONE. 1061 osseous system. We shall, therefore, in this place only consider theoutlines of the changes as they more particularly affect the joints. The separate diseases of bones which affect the joints are few,and excluding the results of injury, the vast majority of them willcome under the heading of either syphilis, tubercle, osteo-arthritis,or Charcots disease. There are, of course, others, such as the acuteseptic inflammations of the bones, which occasionally play a parthere ; but as a matter of fact, these almost invariably stop short atthe epiphysial lines, and as the latter in most cases lie outside thecapsule of the articulations, the chanc
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