On anormal nutrition in articular cartilages / by P. Redfern.

  • Redfern, Peter, 1821-1912.
Date:
1849-1850
Catalogue details

Licence: Public Domain Mark

Credit: On anormal nutrition in articular cartilages / by P. Redfern. Source: Wellcome Collection.

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    absorbed, changes which Sir B. Brodie believed to require the exist¬ ence of vessels in the interior of the cartilage for their accomplish¬ ment. This author, in the 3d edition of his very valuable work on Diseases of the Joints, states his belief, that ulceration or absorption of articular cartilages may take place from the action of their own vessels, and that ulceration may arise from:—u 1st, Disease originating in the neighbouring soft parts, especially inflammation of the synovial membrane; 2dly, it may depend on a morbid condition of the car¬ tilage itself; or, 3dly, on a chronic inflammation of the surface or substance of the bone with which it is connected; 4thly, it may be the result of a peculiar alteration in the condition of the cancellous structure of the bones, which is met with in young scrofulous per¬ sons.” In his additional notes on ulceration of articular cartilages, Sir B. Brodie states, that he has not been able to satisfy himself as to the exact nature of the ulceration resulting from inflammation of the synovial membrane; and then, referring to cases of inflammation of the synovial membrane, in which ulceration begins in the centre of the cartilage, he states that of such cases neither Mr Key’s hypo¬ thesis, nor any other, affords any reasonable explanation. Of the degeneration of cartilage into fibrous structure, he remarks : u I have no doubt that it often exists where it is never followed by ulceration, but I am also well assured that, in many other instances, it precedes, and, in fact, forms the first stage of the disease.” Mr Key1 describes three forms of ulceration of articular cartilages accompanying respectively acute or chronic inflammation of the joint, or strumous disease of the bone, as well as u that in which the struc¬ ture appears to undergo a change in its organisation, independent of foreign agency.” In three of these conditions, he says, u the car¬ tilage is not absorbed per se, but through the agency of a struc¬ ture, probably evolved for the special purpose of completing that process;” and the fourth is u the result of disorganisation of tex¬ ture.” Mr Key2 states :—u The absence of all action in the cartilage, and a total want of vascularity in those parts where ulceration appears to be most active, were the circumstances that first led me to look for some agent in the work of ulceration.” This statement occurs in speaking of ulceration caused by inflammation of the synovial mem¬ brane from wounds. Mr Key believes that the highly vascular membrane which covers the cartilages of such joints causes ulcera¬ tion to take place in them, and that it progresses in proportion to the amount of the inflammation and the vascularity of the newly-formed membrane. And yet, in his further remarks3 on ulceration result¬ ing from inflammation caused by wounds, the same author adds :— u In these cases the cartilage is found often to be extensively de- 1 Medico-Chirurgical Transactions, vols. xviii. and xix. 2 Ibid, vol. xviii. p. 235. 3 Ibid, vol. xviii. p. 148.