. The principles and practice of surgery. l the malady has made great progress, namely,necrosis of various portions of the pelvic bones, intra-pelvic abscesses,and in a few cases penetration of the acetabulum by the head ofthe femur. Acetabular arthritis, like arthritis, is liable to occur at any period oflife. The prognosis is always unfavorable. Femoral Arthritis. Syn., Femoral Ostitis and Osteo-myelitis.—Chronic inflammation invading primarily the upper end of thefemur is probably the most frequent source of the so-called hip-disease. Occurring most often in early life, and in children of a
. The principles and practice of surgery. l the malady has made great progress, namely,necrosis of various portions of the pelvic bones, intra-pelvic abscesses,and in a few cases penetration of the acetabulum by the head ofthe femur. Acetabular arthritis, like arthritis, is liable to occur at any period oflife. The prognosis is always unfavorable. Femoral Arthritis. Syn., Femoral Ostitis and Osteo-myelitis.—Chronic inflammation invading primarily the upper end of thefemur is probably the most frequent source of the so-called hip-disease. Occurring most often in early life, and in children of astrumous habit, it is exceedingly insidious in its approach, and pe-culiarly intractable in its progress. It is essentially the same malady HIP-JOINT DISEASE. 433 as that which, having attacked the lower epiphysis of the femur, orthe upper epiphysis of the tibia, is known as white swelling. Themorbid changes which occur in the interior of the bone have beenvariously interpreted; by some the cheesy infiltrations are considered Fig. Acetabulum and Femur in a ease of Hip-disease. as strumous deposits; by others as tuberculous; still others, regard-ing scrofulosis and tuberculosis as identical, apply to these morbidproducts either one of these terms indifferently ; but later pathologistsrecognize in them nothing more nor less than the infiltrations anddegenerations of tissue consequent upon chronic inflammation, and intheir nosology white swelling is circumscribed osteo-myelitis orostitis, liable to be followed by solidification, expansion, suppuration,necrosis from strangulation, and caries. To this latter theory I donot hesitate, in view of the evidence now before me, to declare my 436 HIP-JOINT DISEASE. adhesion. Nevertheless, there can be no doubt that a strumous or a tu-berculous diathesis constitutes an active predisposing cause in a largeproportion of cases—a doctrine which is in no way inconsistent withthe fact that in most examples the development of the malady m
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