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.

    43/578 page 21
    Microscopical Structure of Diseased Tissue and Caseation of Liflammatory Product. — Rokitansky, Virchow, Koster, Kiener, and others liave shown that the primary nodules in bone and synovial membrane during the early stages of tuber- cidar disease show, under the microscope, the same structure as miliary tubercle in the lungs. The primary inflammatory product is a minute tubercle, hi wliicli the same histological elements can be found and can be seen to be arranged in a similar manner as in miliary tubercles in the lung. The primary tubercle here, like in thfe rung, is an avascular struc- ture, and undergoes the same secondary pathological changes as in tlie latter organ. Coagidation necrosis and caseation of the inflammatory jproduct takes place, slower, hid loitJi the same regularity in tuhercidar products in hone and joints as m pulmonary pththisis. The very fact that the inflammatory product in hone and joint ttdjerculosis presents the same histo- logical structure, and is sithject to the same pathological changes as tuhercle in the lungs, warrants the assertion that they are produced by the same cause and undergo analogous degenerative processes. Reaction to Tuherculin.—One of the benefits derived from the treatment of tubercular affections with Koch's lymph is the knowledge gained, that tubercular affections of bone and joints react under tlie use of tuberculin in the same manner and with the same promptness as tubercular lesions in the lungs. The general reaction is often very intense, as I liave observed a tem- pfratnre of nearly 106° F. six liours after injection of 5 milli- grammes of tuberculin in a case of uncomplicated synovial tubcrcidosis in a girl 18 years of age, who had a normal tem- IX'rature Ijofore the injection was made. The local reaction is prompt, and sets in witliin twelve hours after tlie administration of the remedy, and consists of swelHng, increased ])ain, and tenderness,—in fact, the substitution of a brief acute attack in place of the chronic inflammation.
    digitised image 1
    digitised image 2
    digitised image 3