396 SURGICAL APPLIED ANATOMY. [Chap. xix. 



enormous increase in the size of the extremity (Co- 

 chin or Barbacloes leg). Its pathology is intimately 

 concerned with the crural lymphatics. " Elephantiasis 

 appears to consist primarily in an inflammatory hyper- 

 plasia of the cellular elements of the connective tissue, 

 in connection with which (according to Yirchow) there 

 is reason to believe that the roots, of the lymphatic 

 vessels are specially involved. Inflammatory over- 

 growth of the elements of the lymphatic glands next 

 ensues, with obstruction to the passage of lymph 

 through them. Then this fluid stagnates in the lym- 

 phatic vessels, which sometimes dilate even to their 

 radicles in the cutaneous papillae, and accumulates in 

 the interstices of the affected tissues, adding to their 

 bulk, and at the same time stimulating them to over- 

 growth .... In some cases of elephantiasis, 

 especially those in which the genital organs or adjoin- 

 ing parts of the thigh or abdomen are implicated, 

 groups of vesicles appear here and there on the affected 

 surface, which are really dilated lymphatic spaces, and 

 which, on rupturing .... discharge consider- 

 able quantities (sometimes several pints at a time) of 

 lymph (Dr. Bristowe). 



The hip joint. The hip joint is an articulation 

 of considerable strength. This strength depends not 

 only upon the shape of the articulating bones, which 

 permits of a good ball and socket joint being formed, 

 but also upon the powerful ligaments that- connect 

 them, and the muscular bands that directly support 

 the capsule. These advantages, however, are to some 

 extent counterbalanced by the immense leverage that 

 can \)e brought to bear upon the femur, and the nu- 

 merous strains and injuries to which the joint is 

 subjected, as the sole connecting link between the 

 trunk and the lower limb. 



The acetabidum is divided into an articular and a 

 non-articular part. The former is qf horse-shoe shape, 



