Licence: Public Domain Mark
Credit: Outlines of human pathology / by Herbert Mayo. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![softened, for the depth of one to two lines. The bone be- yond was perfectly healthy, [g. 60.] E. D., aetat. twenty, was admitted, in November 1833, into the Middlesex Hospital. Three years previously, she had been attacked with pain and swelling of the left elbow joint; which being treated with leeches and embrocations, went away in nine months. Shortly after her recovery, the left knee began to swell at the lower and fore part: the swelling was attended with pain, which, although constant, was severe at times only; she thought it rheumatism, and wore flannel round the joint. A year before her admission, the disorder in the knee became more serious : at times it confined her to her bed. The joint was hot, stiff, and pain- ful. Several blisters were then applied in succession, and with some advantage. Leeches, fomentations, cold embrocations, bandaging, were tried, but were ineffectual. At the time of her admission, and for a month previously, she had been suffering the acutest pain, which the least pressure or motion aggravated to intensity. ' The knee was hardly swollen ; it was a little bent. There was no impedi- ment to further flexion but the pain it gave. The pain was severest beneath the patella : it extended through the thigh and leg. Having tried local bleeding, fomentation, a large issue, and opium, without any mitigation of her sufferings, I amputated the limb. Upon opening the knee joint, the capsular synovial mem- brane was found to be inflamed and thickened, presenting a jelly-like granulated surface, which extended a little way over the cartilages of the condyles. The cartilages were but partially ulcerated towards the joint, and for a very small extent; but they tore readily from the bones. There were parts at which it was evident they had been already discontinuous, the surface of the cartilage being slightly excavated, and the opposite surface of the bone ulcerated, and extremely vascular. At other parts the cartilage, when being separated, tore away with it numerous granules of bone. This arose from the surface of the bone, for the depth of a line to two lines, having been highly inflamed, and](https://iiif.wellcomecollection.org/image/b21066735_0080.jp2/full/800%2C/0/default.jpg)
