Imatges de pàgina
PDF
EPUB

From the diseased bone vessels carrying red blood shoot into the cartilage, which afterwards ulcerates in spots, the ulceration beginning on that surface which is connected to the bone. The ulceration of the cartilage often proceeds very slowly. I have known a knee amputated on account of this disease, in which the cartilage was absorbed, for not more than the extent of a sixpence.

Occasionally, but not often, a portion of the carious bone dies, and exfoliates.

As the caries of the bones advances, pus is collected in the joint. At last the abscess bursts externally, having formed numerous and circuitous sinuses.

Inflammation takes place of the cellular membrane, external to the joint. Serum, and afterwards coagulable lymph, is effused, and hence arises a puffy elastic swelling in the early, and an œdematous swelling in the advanced, stage of the dis

ease.

Scrophula attacks only those bones, or portions of bones, which have a spongy texture, as the extremities of the cylindrical bones, and the bones of the carpus and tarsus; and hence the joints become affected from their contiguity to the parts which are the original seat of the disease. I have never met with an instance of the alteration of structure, which has been just described, in the cranium, nor in the middle of the cylindrical bones.

Examples of this disease occur in almost every joint of the body, but oftener in those of the carpus and tarsus than in any other. In one instance which came under my notice, nearly all the joints of the body were affected at the same time in the same individual.

It should be observed, that in some other cases besides those of scrophulous affection, the bones are found to be more or less altered from their natural texture. When a bone is extensively carious, it appears as if the absorption of the earthy part takes place more rapidly than that of the animal matter, and hence it becomes preternaturally soft in the neighbour

hood of the carious surface, at the same time that it assumes a dark colour and has a fœtid smell, from the lodgment of matter in the cancelli. In cases where a disease has evidently originated in the soft parts of a joint, I have occasionally found the bones to have lost much of their original hardness of texture, though the alteration has been in a much less degree than in scrophulous bones, and without the deposition of yellow cheesy substance in the cancellous structure. Some circumstances induce me to suspect that mere want of use is sufficient to occasion a deficiency in the secretion of phosphate of lime, and, indeed, the analogy of what may often be observed after a fracture, renders this highly probable. When the two broken ends of a bone have become united by callus, the callus, in some instances, does not become ossified, while the patient continues in bed, and in a state of rest; but if he moves about on crutches, and exercises the limb, the ossification is speedily produced.

The diseases which have been described in the foregoing sections are those of the most frequent occurrence. There are some other affections to which the joints are liable, but a brief notice of these will be sufficient.

1. Occasionally inflammation takes place on the articulating extremity of a bone, and an abscess forms and bursts into the joint. Where this happens, there is sometimes a fresh formation of bony matter in consequence of inflammation, and ossification of the periosteum, and this constitutes the only species of diseased joint which has come under my own observation, in which an actual enlargement of bone takes place. Where the soft parts of a joint are considerably thickened, a feeling is sometimes given to the hand, as if the bones themselves were increased in size; but my friend Mr. Lawrence, some years ago, observed and pointed out that this feeling is deceptive.

2. I have known an instance, in which, without any evident

cause, a large portion of the head of the tibia died, and exfoliated, and the destruction of the knee joint was the consequence.

3. The loose bodies, which are occasionally found in a joint, have been so frequently described by writers, that it might appear unnecessary to offer any observations on the subject. But I have met with two cases in which the loose bodies were of a different nature, and had a different origin, from those which are ordinarily met with. It not unfrequently happens, that from some morbid action, a bony ridge is formed, like a small exostosis, round the margin of the cartilaginous surfaces of the joint. In the two instances, to which I allude, this preternatural growth of bone had taken place, and in consequence of the motion of the parts on each other, portions of it had been broken off, and lay loose in the cavity of the joint.

4. The effects of gout on the joints are very remarkable. The cartilages are absorbed: the exposed surfaces of bone, are entirely, or partially, encrusted with white, earthy matter, which I conclude to be urate of soda, and sometimes they have the appearance of being formed into grooves, as if they had been worn from their friction on each other. In some cases, repeated and violent attacks of gout occasion complete anchylosis.

I am induced to hope, that the foregoing observations will be found to lay the foundation of a better arrangement of the diseases of joints, than that which has usually been adopted: but I am well aware that the subject is by no means exhausted. I shall endeavour to avail myself of such opportunities as may occur of prosecuting the investigation further; and, in the mean time, I beg the indulgence of the Society for not having already rendered it more perfect. The study of pathology is indeed attended with peculiar difficulties. There is no science in which a greater number and variety of facts demand our notice; none in which a just and accurate knowledge of facts.

is less easy to be obtained; or in which the phenomena are so little capable of being reduced to general laws. A multitude of causes, too minute to be detected, silently operate, sometimes to modify and alter the effects of the same morbid action; at other times, to give a similar form and character to different diseases. Particular periods and particular climates produce their own peculiar maladies; and hence, the labours of those who have gone before us, or who have made their observations in other countries, are often of little service towards promoting the researches in which we ourselves may be engaged. All these circumstances render it impossible to bring pathology to that degree of perfection, which has been attained in some other branches of knowledge; but the difficulty of the science does not render it less important to human nature, nor less necessary to be pursued by those engaged in the medical profession.

Account of a Family having Hands and Feet with supernumerary Fingers and Toes. By ANTHONY CARLISLE, Esq. F. R. S.

[From the Transactions of the Royal Society of London]

ZERAH COLBURN, a native of the township of Cabot, in the state of Vermont, in North America, has been lately brought to London, and publicly exhibited for his extraor dinary powers in arithmetical computations from memory. This boy has a supernumerary little finger growing from the outside of the metacarpus of each hand, and a supernumerary little toe upon the outside of the metatarsus of each foot. These extra fingers and extra toes are all completely formed, having each of them three perfect phalanges with the ordinary joints, and well-shaped nails.

Abiah Colburn, the father of Zerah, has five fingers and a

thumb upon each hand, and six toes on each foot; he has also five metacarpal bones in each hand, and six metatarsal bones in each foot. The extra limbs have distinct flexor and extensor tendons.

The wife of Abiah Colburn has no peculiarity in her limbs. During the existing marriage she has borne eight children, six sons, and two daughters. Four of those sons inherit the peculiarity of their father more or less complete, while the two daughters are free from the family mark, as well as two of the sons, namely, the fourth in succession, who, was a twin, and the eighth.

The eldest son of these parents, named Green Colburn, has only five toes on one of his feet, but the other foot and both his hands possess the extra limb.

The second child, Betsy Colburn, is naturally formed.

The third, Zebina Colburn, has five fingers and a thumb upon each hand, and six toes upon each foot.

The fourth and fifth were twin brothers, and named David and Jonathan; David, who is dead, had nothing of the father's mark, but Jonathan has the peculiarity complete.

The sixth, Zerah Colburn, the extraordinary calculating boy, is marked like his father, as before described.

The seventh, Mary Colburn, is naturally formed.

The eighth and last child, Enos Colburn, is also exempt from the father's peculiarity.

Besides the persons I have mentioned, this hereditary redundance of limbs has been attached to the little fingers and to the little toes of several of the ancestors of the family. The mother of Abiah Colburn brought the peculiarity into his family. Her maiden name was Abigail Green; she however had not the extra finger on one of her hands; the other hand and her feet were similarly marked with those of her son Abiah.

David Colburn, the father of Abiah, had no peculiarity. By his marriage with Abigail Green he had three sons and one daughter. Two of these sons and the daughter were fully

« AnteriorContinua »