494 Diseases of Joints. 



backwards by development of bone round the cotyloid margin. 

 The surface of the interior is porous and eburnated, like that of 

 the femur. B. C. ii. M. 81. 



7. 176. Advanced Arthritis Deformans. — Upper end of a left 



femur — macerated, illustrating the above. 



While there has been enlargement round the margin of the 

 head of the femur, especially in front, there has been great 

 absorption of the upper part, which thus is now below the 

 level of the top of the great trochanter. This upper surface is 

 fairly smooth, but has little or no eburnation, probably because 

 locking prevented movement. The rest of the articular surface 

 is irregular. The small trochanter has been partly absorbed. 



This specimen was formerly described as a united fracture 

 of the neck of the femur. F. P. C. 95. 



177. Symmetrical Alterations in the Head and Neck of 

 Femora, probably from Arthritis Deformans.— Upper 



portions of a right and left femur, with a vertical section of the 

 head and neck of the left — macerated, illustrating the above. 



" The man, aged 50, had had several attacks of acute rheumatism. 

 On admission to the hospital, he complained of a gnawing pain in the hip 

 and shoulder-joints, and the motions of the hip-joint were considerably 

 impaired. He died from exhaustion from a large lumbar abscess. He had 

 been a shoemaker," 



" The shaft and trochanters were unaffected, but the neck 

 was extremely short, and the head flattened and expanded. 

 The actitabula were correspondingly large, shallow, and 

 irregular. Instead of being an inch higher than the trochanter 

 major, the highest part of the head was three-quarters of an. 

 inch lower than the trochanter. The neck was only half an 

 inch in length, and was planted lower down on the bone, 

 especially near the great trochanter. The margin was extended 

 so as to form an overhanging ledge below, behind, and before. 

 The outline of the head Avas flat below and arched above, 



