NAVICULAK DISEASE. 353 



divided ends of the tendon were some distance apart, and they 

 Ijore a jagged appearance, owing to the formation of fringe-like 

 processes of a gelatinous material, containing some blood-vessels, 

 which gave to the new formation an appearance similar to that 

 of pale muscular tissue. The inner or anterior surface of the 

 tendon bore evident traces of ulceration and gelatinisation ; and 

 it had an appearance of ecchymosis in its structure. 



The inferior broad navicular ligament was ruptured, its divided 

 edges presenting the same appearances as those of the tendon, 

 but were considerably more vascular. 



Appearances of the Navicular Bone. — Externally, its postero- 

 inferior surface presented no distinct traces of ulceration ; the 

 cartilage was absorbed ; and the bone presented a vascular dirty- 

 brown appearance, and its articular cartilage was covered over by 

 a vascular membrane, the processes of which could be distinctly 

 seen penetrating the structure of the bone, and extending over 

 more than one-third of the bursal surface. The bone was frac- 

 tured at about haK an inch from its right extremity. 



(ll.) PATHOLOGICAL ANATOMY OF GELATINOUS DEGENERATION, OR 

 STRUMOUS DISEASE OF THE JOINTS, IN THE HUMAN BEING. 



" Gelatinous degeneration may attack any joint in the body, 

 but those most frequently affected are the knee, elbow, and 

 ankle. I shall take the knee-joint as an illustration, as the 

 disease, especially that of the low chronic form, is most fre- 

 quently there situated. 



" In about six weeks after the commencement of the disease, 

 a partial swelling is found on either side of the patella, extend- 

 ing towards the posterior aspect of the lateral ligaments. This 

 increases around the patella, and the markings of the bone are 

 gradually lost in it. The swelling presents either a peculiar 

 elastic or a doughy feel. As the disease goes on, the symptoms 

 become more marked, the colourless swelling increases, the joint 

 becomes more tense, and has a glazed appearance. 



" The pathological condition leading to these symptoms con- 

 sists in a peculiar degeneration of the synovial membrane. 

 This exists under two forms, and these have been described 

 under two separate names — the gelatinous and pulpy degenera- 

 tion : but they are truly identical in symptoms, and as regards 

 2 a 



