A system of surgery : pathological, diagnostic, therapeutic, and operative . e disease is far advanced, the fluctuation is renderedvery faint in consequence of the fungous condition of the synovial membrane,the leg is excessively wasted, and the foot has a distorted or twisted appearance, CHAP. IX. TDBERCULOSIS OP KNEE-JOINT. 1021 as if it were rotated upon its axis,or partially dislocated. If sup-puration takes place, the matterusually collects in front of thejoint, diffusing itself more or lessextensively in the subcutaneouscellular tissue of that region. In the treatment of this dis-ease th
A system of surgery : pathological, diagnostic, therapeutic, and operative . e disease is far advanced, the fluctuation is renderedvery faint in consequence of the fungous condition of the synovial membrane,the leg is excessively wasted, and the foot has a distorted or twisted appearance, CHAP. IX. TDBERCULOSIS OP KNEE-JOINT. 1021 as if it were rotated upon its axis,or partially dislocated. If sup-puration takes place, the matterusually collects in front of thejoint, diffusing itself more or lessextensively in the subcutaneouscellular tissue of that region. In the treatment of this dis-ease the foot should be placed ata right angle with the ^leg andthe parts well supported withsuitable splints, so as to maintainthem in an easy, relaxed and quietposition. Linear cauterizationmay be performed, or, what ispreferable, a small issue should beestablished with the hot iron justabove each malleolus. Promptvent is afforded to pus ; and, ifthe joint cannot be saved, resec-tion or amputation is resortedto, according to the judgment ofthe surgeon. 9. KNEE-JOINT. Fig. Tuberculosis of the ankle. Fis. 489. This joint, owing to the greatsize of its articular surfaces, its extensive motions, and its exposed situation, is,next to the hip, more frequently the seat of tuberculosis than any other joint inthe body. While the disease is most commonin young persons before the age of fifteen, itis often met with in young adults, and is gene-rally excited under the influence of externalviolence, as a blow, fall, or twist, acting upona depraved constitution. The pain which attends this disease, andwhich is generally very severe, even at thecommencement of the, attack, is almost inva-riably situated in the direction of the innercondyle of the femur, at the lower part of thepatella, or at the inside of the head of thetibia; seldom at the outer part of the great uniformity of this occurrence hasled to various speculations as to its cause, butas yet no satisfactory explanation has
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