The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . cheesy consequence of this disorganisation ofthe osseous tissues, the incrusting carti-lage becomes detached, its under or at-tached surface softened, and at lastperforation takes place, as in a pre-ceding cut (Fig. 436 6, p. 219), taken fromthe tibia of a boy whose limb I ampu-tated for acute disorganisation of theknee-joint, following carious disease ofthe head of the tibia. This process ofdisintegration, and at last perforationand erosion of the cartilage, takes placein a direction f
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . cheesy consequence of this disorganisation ofthe osseous tissues, the incrusting carti-lage becomes detached, its under or at-tached surface softened, and at lastperforation takes place, as in a pre-ceding cut (Fig. 436 6, p. 219), taken fromthe tibia of a boy whose limb I ampu-tated for acute disorganisation of theknee-joint, following carious disease ofthe head of the tibia. This process ofdisintegration, and at last perforationand erosion of the cartilage, takes placein a direction from below upwards. Sosoon as perforation occurs, the whole ofthe interior of the joint becomes acutelyinflamed, and suppuration is set up in it,the ligaments loosen, and complete disorganisation ensues (Fig. 437).On examining the diseased patch or cartilage in cases of this kind, itwill be found to correspond to the carious or tuberculous bone, fromwhich it is separated by some bloody fluid ; it will also be seen that theunder edges of the erosion or perforation in the cartilages are separated. Fig. 437.—Interior of Kuee disorganisedby Acute Pyaemic Inflammation. DISEASE OF CARTILAGE. 225 to some extent from the subjacent bone, from which thej readily peeloff, and that they are bevelled off towards the aperture. 3. That cartilage is susceptible of Primary Change of the Nature ofInflammation or Ulceration^ induced by tlie action of its own vessels,was the opinion of Brodie, Mayo, and Listen, all of whom had observedtrue vascularisation of cartilage. This condition, however, is extremelyrare, and is certainly not one of the more common forms of joint-disease,seldom occurring except in the more chronic stages of arthritis. While, however, inflammation, as the term is commonly understood,is of rare occurrence as a primary change in a cartilage, certain of theaccessory or constituent conditions of the process are liable to be metwith in this tissue. The observations of Goodsir, of
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