2i 8 PHYSIC 



system, with its aponeurotic coverings and interlying 

 fibrous, fibre-elastic, and connective layers or processes of 

 bounding and supporting tissue, its tendons, with their 

 sheaths and more or less lubricating surrounding material, 

 and their final attachments to the bones, where the peri- 

 osteum and ends of insertion of the tendons become so 

 intimately blended as to make the union as complete as 

 is possible or compatible with the junction of two histo- 

 logically different structures, besides the periosteum, by 

 continuity along the shafts of the bones of the limbs, its 

 reflection over the epiphyses of these bones, its junction 

 and blending with the ligamentous structures of the 

 joints, and its ultimate association with the joints through 

 contact with their cartilages and synovia! membranes. 

 From this statement we want to make it clear that a bond 

 of union is effected or exists between the structures named 

 by continuity and contiguity of texture of such an intimate 

 character that a passage by capillary and osmotic circulation 

 is possible, and not only possible, but in more or less 

 constant operation through the implied inter-textural 

 spaces, lacunae, and channels. 



On to the nervous system we shall now tack all this 

 complicated array of highly organised structures, indeed, 

 we must recognise that all these structures belong to and 

 constitute, so to speak, an appendage and part of the 

 nervous system, and that the nervous system is as inti- 

 mately blended with the muscular system as the muscular 

 system is blended with the skeleton through tendons, 

 periosteum, ligaments, and joints. 



This association and interdependence of the nervous 

 system, the muscular system, and the osseous system, 

 constitutes the basis on which we must elaborate our 

 contribution to the literature of that far-reaching subject, 

 rheumatism. 



Rheumatism must be regarded as an affection, ranging 

 from the slight and almost imperceptible "rheum" of our 

 forefathers to the acute rheumatism of the present day, 

 ranging also from the absolute helplessness, fear, and 

 dread, of acute rheumatism to the unyielding stiffening 

 and deformity of chronic rheumatic arthritis. 



These two varieties of the affection may be looked upon 



