Anormal nutrition in the human articular cartilages, with experimental researches on the lower animals / by P. Redfern.

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

Licence: Public Domain Mark

Credit: Anormal nutrition in the human articular cartilages, with experimental researches on the lower animals / by P. Redfern. Source: Wellcome Collection.

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    days, the bone in contact with the wire was softened; and, in both cases, the whole lower end of the femur was highly vascular. Con¬ siderable lameness followed both these operations, and continued for a week or ten days, after which it could scarcely be perceived, unless during unusual movements of the limbs. From what has preceded, it is obvious that anormal nutritive changes can be induced in the cartilages of the lower animals, with considerable facility, by irritations of various kinds—such as the making of incisions into them, the insertion of setons, the application of ligatures, actual cautery, acids or alkalies :—again, they occur as the result of inflammation in the synovial membrane, which leads to the supply of nutritious fluid to the cartilage in increased quantity, and of anormal composition ;—and, further, they result from unequal pressure upon articular surfaces, and appear to arise when the pres¬ sure is diminished, as well as when it is increased.1 When changes are induced in the costal, articular, or nasal cartilages, by any cause whatever, they are essentially similar in all cases, and affect both the cells and inter-cellular substance. The cells become enlarged, round¬ ed, or oblong, and irregularly arranged; their nuclei giving place to a multitude of corpuscles, or to a series of granules. The walls of the cells next become identified with the hyaline substance, when the corpuscles are set free, and begin to undergo other changes, elongat¬ ing and becoming very evidently converted into the nuclear fibres of fibrous tissue, or reduced to small patches of granules, which may only become visible on acting upon the fibrous mass by acetic acid. During the enlargement of the cells, and especially at the period of discharge of their contents, the hyaline matrix becomes softened, and allows the corpuscles to be freely moved in it, or pressed out alto¬ gether ; whilst, at a subsequent period, fibres appear in the inter¬ spaces of the corpuscles, and take on the characters of those of the white fibrous tissue. In this way, both elements of the cartilage are concerned in the formation of the fibrous membrane, which is des¬ tined to heal the breach in the tissue, for the hyaline substance is converted into the white fibres, and the corpuscles of the cells into nuclear or elastic fibres.—Or, an altogether different result may take place, especially in the case of articular cartilages, the whole thick¬ ness being converted into a calcareous mass; the cartilage cells be¬ coming lacunae, and calcareous matter being also deposited in the intercellular substance, rendering it dark and incapable • of transmit¬ ting the light, the surface all the while remaining perfectly smooth and on its former level. A very important feature in the changes induced in healthy car¬ tilages by injuries, is their decided tendency to go on to a perfect cure, by the formation of a dense fibrous membrane, or a smooth 1 The disadvantages of maintaining joints in one position, for lengthened periods, have long been familiar to surgeons.