44 PERSONAL APPEARANCES IN HEALTH AND DISEASE. 



destruction of the joint itself and distortion of the limb. 

 To name and illustrate only one of them. The hip-joint 

 is frequently attacked with inflammation of a particular 

 kind in children of what is called strumous constitution. 

 In its early stage, this disease shows itself by the attitude 

 of .the limb almost as much as by any subjective 

 pain. The child fears to put its foot down, and stands 

 with the affected leg raised and turned inwards, so that 

 only the tips of the toes rest on the ground ; and actually 

 there may be some shortening of the limb, whilst if the 

 child be laid on its face, the normal fold of the buttock 

 on that side will be almost if not entirely obliterated, the 

 great protuberance itself being flattened out as compared 

 with the opposite buttock. If the disease run its course, 

 all these alterations become more marked, and the limb ac- 

 tually grow shorter, from disappearance of the head of the 

 bone, and finally even firm union will take place between 

 the hip and thigh bones. Then in walking the thigh 

 moves with the hip, the body is bent, and one cause of 

 spinal curvature is established. 



" Housemaid's knee " is a swelling produced by en- 

 largement of a sac containing fluid which exists beneath 

 the skin in front of the knee-cap. Its enlargement is 

 brought about by constant kneeling on hard surfaces 

 without any protection pad, so that there is much pres- 

 sure upon this part. Small elastic and occasionally 



