Diseases of the joints and spine / by Howard Marsh.

  • Frederick Howard Marsh
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the joints and spine / by Howard Marsh. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    73/564 (page 53)
    rheumatism is a term to.which no very precise meaning can be attached Further investigation has led to tlie breaking up of the disorders now ranged under the name of rheumatism into independent groups, and the like sub- division will also be called for in dealing with the con- ditions hitherto classed under the term osteo-arthritis, and its synonyms. Various writers, indeed, have already drawn attention to the widely dissimilar affections that are ranged under these phrases (pages 62, 69), and have pointed out that all the anatomical changes which have been ascribed to osteo-arthritis are found in such essen- tially different joint affections as urethral arthritis (page 23), the arthritis occasionally following scarlet and other specific fevers (page 21), and in haemophilia (page 164). Thus future subdivision must occur, and as it advances, names hitherto employed will either fall into disuse, or have some definite meaning assigned to them. In the meantime, a general heading is required, and osteo-arthritis seems the best term to adopt. It involves no pathological theory, while at the same time it serves to suggest the most obvious and constant anatomical features that are met with in the different forms of disease included under it. The general clinical characters of osteo-arthritis are well seen in the small joints of the fingers, and in the knee. The affected joint becomes gradually stiff, enlarged, painful, and distorted, and is found to creak or grate when it is moved. These symptoms are explained when an advanced example is dissected. It is then seen that the cartilages are worn away and that the synovial membrane is extensively affected, so that its power of secretion is impaired, the ligaments and surrounding tendons are destroyed, and the articular ends of the bones are altered in shape, and in their relations to each other. A question that has often been discussed is, whether this remarkable affection is primarily a chronic inflammatory