. The principles and practice of modern surgery . cannot, sfny!* Brf)(lie, assert tlial tliis intMnbrnne is never ultimately converted intothe true cartilagitioiis slnictMre. In other cases, a cunipnct layer of bone is tjenerntedon the earinuH surface. Iti others, there is fonnil a thin layer of hard scmi-trnnsparentfiubstnnee of a urny colfinr. and preseniinjc an irrccniarly ;.rniinlaled surface. Some-times, , the bend of the bono is covered -with a crust of bony matter, of compacttexture, of a white colour, smooth, and like polished marl)lc. Hrodie on tlie Joints, tthedit. p. 103
. The principles and practice of modern surgery . cannot, sfny!* Brf)(lie, assert tlial tliis intMnbrnne is never ultimately converted intothe true cartilagitioiis slnictMre. In other cases, a cunipnct layer of bone is tjenerntedon the earinuH surface. Iti others, there is fonnil a thin layer of hard scmi-trnnsparentfiubstnnee of a urny colfinr. and preseniinjc an irrccniarly ;.rniinlaled surface. Some-times, , the bend of the bono is covered -with a crust of bony matter, of compacttexture, of a white colour, smooth, and like polished marl)lc. Hrodie on tlie Joints, tthedit. p. 103. I Refer to the Index. * Lectures, ^Icd. Gaz. vol. xxxvii. ARTICULAR CARIES. 271 fomentation cloth, so that the matter may gently exude. No roughsqueezing is admissible. If the puncture heals, another may be madewhen necessary—if it remains open it should be made large enouo-h to letthe matter flow out freely as soon as it is secreted. The case must thenbe treated according to the directions for abscess in joints. SECTION V. ARTICULAR Fig. 67. Caries of the head of a bone is not an uncommon cause of ulcera-tion of the adjacent cartilage and disorganization of the joint. Theaffected bone is found to be soft, red, and vascular, and deficient in earthymatter, so that it is easily cut or crushed; its cancelli are filled with areddish fluid, and in scrofulous cases acheesy matter is deposited in to this softened state of the bone,the cartilage peels off from it peeled off, its under surface is pro-bably found ulcerated; and between itand the bone there is a small quantity ofhighly vascular lymph growing out of thecarious cancelli, which probably is the in-strument in removing the cartilage, afterthe manner already detailed. When thecartilage is perforated, inflammation and suppuration ensue in the joint,and the case then pursues the same course as the ulceration of cartilage,although a slower one. In some few cases, from therapidity of the caries,
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