Archive image from page 617 of The cyclopædia of anatomy and. The cyclopædia of anatomy and physiology cyclopdiaofana0401todd Year: 1847 596 ABNORMAL CONDITIONS OF THE SHOULDER JOINT. has been altogether confined to his bed, as he could not stand upright, much less walk, when the writer visited him in August, 1847. His hips, knees, and elbow joints were semiflexed and rigid, his wrist extended, his fingers and toes presented the ordinary characteristic distortion belonging to rheumatic gout, or chronic rheumatic arthritis. Although the shoulder joints in this case had lost much of their muscu
Archive image from page 617 of The cyclopædia of anatomy and. The cyclopædia of anatomy and physiology cyclopdiaofana0401todd Year: 1847 596 ABNORMAL CONDITIONS OF THE SHOULDER JOINT. has been altogether confined to his bed, as he could not stand upright, much less walk, when the writer visited him in August, 1847. His hips, knees, and elbow joints were semiflexed and rigid, his wrist extended, his fingers and toes presented the ordinary characteristic distortion belonging to rheumatic gout, or chronic rheumatic arthritis. Although the shoulder joints in this case had lost much of their muscular covering, the deltoid and cap- sular muscles being in a state of atrophy, yet the bones of the articulation seemed much enlarged, and the heads of both humeri were evidently situated much above the level of the coracoid process. He did not complain of much pain in the shoulders ; the constant torture he endured in the right hip and both his knees quite distracted his attention from all minor suffering. He stated that he had a ' crackling ' sensation in all his joints when- ever they were moved; that his sufferings were influenced by the weather, and that he endured more pain during the frost of winter than at any other time. The patient died worn out by pain and irritative fever, attended with severe diarrhoea. Post'inortem examination. — Dr. R. Smith assisted the writer in this examination. As the body lay on its back on the table, the hips, the elbows, and knee joints were semi- flexe 1, and could not be extended, but they permitted of flexing to a very trivial degree. When any of the affected joints were moved, the characteristic crepitus, or crackling, so often alluded to, was elicited now as during life. The head of the os humeri of each side was drawn up much above the level of the coracoid process, and was preter- naturally advanced. Upon rotating the hu- merus, a marked crepitus was evident in these as well as all the other joints. On re- moving the integument o
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