Tuberculosis of bones and joints / by N. Senn.

  • Nicholas Senn
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculosis of bones and joints / by N. Senn. Source: Wellcome Collection.

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    made by the last two authors are too unimportant I'or further con- sideration as a scientific or even practical distinction between scrofula and tuberculosis as applied to affections of the bones and joints. The surgeon must recog7iize every lesion as tuber' cular in its origin, nature, and course iii which the bacillus of tubercxdosis can be found, from toliich successful cultivations can be made, and ivith which the disease can be artificially pi'oduced in animals by inoculation. Watson Clieyne asserts that as the result of las numerous experiments bacilli can always be, found in the tissue-lesions, but that in most cases they were extremely few iu number. He believes that the difficulty in finding tliem more constantly and in greater number is owing to our present defective means for staining them. Direct Infection of a Joint through a Wound or Extension of Disease to it from a Tubercular Focus near a Joint.—A few well-authenticated cases are on record in which infection occurred by the entrance of the tubercular virus into a joint through a penetrating wound. Middledorpf ( Ein Fall von Infection einer penetrirenden KniegelenksAvunde durch tuberculoses Virus. Fortschritte der Medicin, 1886) reports the case of a healthy carpenter who opened his knee-joint by the cut of an axe and dressed the wound with a soiled handkerchief. The wound healed kindly, but later the joint became swollen, tender, and painful. Kesection Avas performed, and on examining the capsule it was found very much thickened. In the granulation tissue bacilli were found. Czerny {Centralblatt f. Chiricrgie, 1886) relates two cases in which tuberculosis followed in granu- lating surfaces tre&,ted by Reverdin's transplantation of skin. In both instances the patients were healthy, and the skin trans- plantation was made during the treatment of extensive burns. The skin was taken from limbs amputated for tubercular affec- tions. In both cases tuberculosis of the adjacent joint occurred, and in one of them tuberculosis of the granulating surface. Vemeuil refers to the case of a student who injured the fold of
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