American practice of surgery : a complete system of the science and art of surgery . he affected joints persists. Associated with these joint disturbances there are very few if any consti-tutional symptoms. The most notable, as well as the most constant, oneis the tendency to constipation, and this seems very frequently to be associatedwith the exacerbations of the disease, seeming to indicate that this conditionis related in some way to the failure to eliminate the waste of the body. NON-TUBERCULOUS INFLAMMATIONS OF JOINTS. 517 Certainly this hypothesis seems to be borne out in the results of
American practice of surgery : a complete system of the science and art of surgery . he affected joints persists. Associated with these joint disturbances there are very few if any consti-tutional symptoms. The most notable, as well as the most constant, oneis the tendency to constipation, and this seems very frequently to be associatedwith the exacerbations of the disease, seeming to indicate that this conditionis related in some way to the failure to eliminate the waste of the body. NON-TUBERCULOUS INFLAMMATIONS OF JOINTS. 517 Certainly this hypothesis seems to be borne out in the results of treat-ment. Encouraging the elimination of the body waste through the excretoryfunctions of the skin, kidney, and intestine, tends to keep these patients freerof symptoms and more comfortable in every way. Special Symptoms.—It will be well now to take up the special manifesta-tions of the disease as it affects particular joints. Feet.—Hypertrophic lesions in the feet are not very common, and must bedistinguished from the spur formations which accompany some of the infectious. Fig. 227.—Shows Marked Hypertrophic Nodes on the inferior border of the tibia, on the scaph-oid, on the back of the os calcis, and on the inferior surface of the latter bone. (Original.) processes, , gonorrhoea. The history and the physical examination, if madeat the time when an infection is fresh, will generally enable one to distinguishbetween the two. The hypertrophic lesions in the feet are usually confinedto the articulations between the scaphoid and astragalus and the scaphoid and theinternal cuneiform. (Fig. 227.) In the x-ray picture they show very well and pro-duce their painful symptoms and restriction in motion by overlapping the articu-lations in the feet where abduction takes place. On physical examinationthere is usually nothing to see, though sometimes the bony spurs are largeenough to cause the skin to protrude above the customary level of the instep,often showing a difference o
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