John Scott on the treatment of diseases of the joints, and of ulcers and chronic inflammation : a new edition, with an introduction and a chapter on the constitutional origin and treatment of diseases of the joints / by William Henry Smith.

  • Scott, John, 1798-1846.
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: John Scott on the treatment of diseases of the joints, and of ulcers and chronic inflammation : a new edition, with an introduction and a chapter on the constitutional origin and treatment of diseases of the joints / by William Henry Smith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    giving rise to disease in them from the absence of exciting causes, a deficiency of earthy matter in the bones renders them liable to be inflamed by mechanical causes, which could not produce any ill effect, were they of their natural firmness. The disease in general arises without any assignable cause, and often occurs in several joints at the same time; which latter circumstance proves that it must be attributable to a cause influencing simultaneously all the joints that are so affected. “ Although the vascularity of bone is perhaps as complete as that of many other structures, it is so sparingly endued with nerves, that it is less readily roused into dis- eased action either from exciting causes or from sympathy,”* Admitting that the structure of the bone were perfect, it cer- tainly would not be liable to be diseased so frequently as this affection occurs. The disease occurs at that period of life, and in that part of the bone, in which there is the largest ]oropor- tion of animal, and the smallest of earthy matter, and in which also the vascularity is the greatest. When it occurs in tlie shaft of the bone, the internal cancellous structure is the part primarily affected. The first stage of the disease may be considered to consist in a preternatural softness of the can- cellous structure of the bone, from a deficiency of its earthy matter. This portion of the bone becomes increased in vascu- larity, in consequence of its being inflamed by the jDressure and contusion it experiences in the motions of the limb. The inflammation is of course modified by the constitutional predisposition of the individual, assuming the form and pro- ducing the eftects of scrofulous disease. As the medulla becomes absoi’bed, the vessels having assumed a morbid action, cannot produce a healthy and natural secretion. The cancelli are therefore filled with a transparent straw-coloured fluid, and subsequently a substance of a caseous consistence will be deposited in them. Sometimes the former will be absorbed, and the cancelli will be found to be wholly occupied by the latter. This substance, like the diseased action which produced it, may pervade the whole extremity of the bone, or it may be * Hunter on Inflammation, &c.