The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . mens, availing myself also freely of the works of earlier investigators, namely, R. Adams, Treatise on Rheumatic Gout; R. W. Smith, on Chronic Rheumatic Arthritis ; and Canton,Surgical and Pathological Observations, a little work from which much information may begleaned. ) * A gentleman of my acquaintance, aged 67, began with a little stiffness in the morning aboutthe joints of the fingers, afterwards the ankles, and then the knees ; subsequently, almost all thejoints were involved, and t
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . mens, availing myself also freely of the works of earlier investigators, namely, R. Adams, Treatise on Rheumatic Gout; R. W. Smith, on Chronic Rheumatic Arthritis ; and Canton,Surgical and Pathological Observations, a little work from which much information may begleaned. ) * A gentleman of my acquaintance, aged 67, began with a little stiffness in the morning aboutthe joints of the fingers, afterwards the ankles, and then the knees ; subsequently, almost all thejoints were involved, and the painful stiffness became continual. My experience is, that although the period of synovial effusion is uncertain, it does not beginuntil the stiffness has lasted some time, often till after nodosities have appeared. In thissequence the knee is sometimes an exception, considerable synovial effusion being much earlierin it than in any other joint. 374 DISEASES OF THE JOINTS. knee, the Gradtia pame may be noticed of tliealso becomes tliigh. With tliis flaccidity, rapid Fig. Arthritis deformans of hand.(After Canton.) more and more decided, and at tlic sametime crepitus, distinctly bony and occasionally veryrough, can be perceived ; in some cases this is soharsh that it can be heard at even a distance fromthe patient; shortly afterwards, abnormal mobilitycan very often be detected. Although space will hardly permit details as to thepeculiar deformation of each joint, yet of two it maybe desirable to speak more particularly. Of all partsthe wrist and hand are the most frequently affected,probably because the most exposed. These ex-tremities are also of use in diagnosis as offering acertain characteristic, and that often when they areby the patient supposed to be exempt. This charac-teristic is adduction of the fingers. At the meta-carpo-phalangeal joint, the index is most affected, andoften previously to the others, so that it tends toovcrla}) the midd
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