250 KNEE JOINT LAMENESS. 



" The fifth form is a curious one ; but I am disposed to believe, 

 from the observations I have made on some few particular cases, 

 that such state will occur. 



''In a joint like the knee, composed of parts but sparingly sup- 

 plied with vessels and nerves, it cannot be expected to find much 

 heat ; this is more often manifested in a part which is well sup- 

 plied with both vessels and nerves, the foot, as I have before re- 

 marked : there is, however, an addition of heat to be detected 

 about the joint, which is more particularly observable when the 

 disease exists in one joint only, by comparison with its opposite. 

 Also, from the small quantity of cellular membrane, and the slight 

 vascularity of the parts, but little if any swelling is present ; and 

 it is not until the disease has existed for some time that enlarge- 

 ment shews itself, and this not always : when it does, it arises 

 from the deposit of lymph, the precursor of ossific deposit. The 

 only form in which swelling occurs, I believe to be, where there is 

 inflammation of the synovial membrane. « 



" When the carpal bones are united by ossific matter, the liga- 

 ment, becoming useless, is consequently absorbed, as we find is 

 the case in other component parts of the animal body; and further, 

 when such consolidation of the minor joints has taken place, the 

 lateral articular surfaces become in like manner useless, and the 

 synovial membrane and articular cartilages are also replaced by 

 bone ; for we must consider, the disease having proceeded only 

 so far as the consolidation of some of the carpal joints, that it is a 

 process of Nature to make stronger that which has been found to 

 be a weak part. 



" Should the injury be repeated after this, the most favourable 

 termination, or extend to other and more important articulations, 

 we find that the result is ulcerative absorption, ending in caries of 

 the body of the bone itself; and this arises from the transverse not 

 admitting of rest like the lateral joints, and from the constant 

 pressure keeping up the diseased action. 



" The bones situate on the inner side of the joint are the most 

 generally affected. From their being more under the centre of gra- 

 vity they receive a larger portion of the weight sustained by the 

 fore extremities than the bones on the outer side of the joint; 



