8i8 



Diseases of the Genital Organs 



ticipates in the pathologic processes, the retracted, closed 

 canal re-opens and urine dribbles from the umbilicus. It 

 is not essential, however, that the infection shall invade the 

 system through the umbilicus in order to cause the uip:bilic 

 lesions. There is clearly a bacteriemia present. The re- 

 cently ruptured veins, arteries and urachus, with retraction 

 of urachal and arterial stumps into the abdomen and maim- 

 ing of the tissues, afford an inviting field for the entrance 



Figs. 233, 234 — Arthritis of Carpus. 



233 — Ivongitudinal section through carpuBr -~ ■'■- ' - 



A, Intra-articular abscesses ; B, pre-carpal abscess ; C, post-carpal abscess. 



234 — Cross section of 233 showing articular surfaces of carpal bones. 



.^.5, Purulent destruction of articular cartilage. 



of bacteria from the blood stream as well as from the ex- 

 terior. The opportunity for bacterial invasion from the 

 blood stream is further favored by the presence of some ne- 

 crotic blood which escaped into the umbilic connective tis- 

 sue during the retraction of the umbilic arteries. An even 

 more dangerous condition exists in the umbilic vein, where 

 some residual blood invites bacteria and, if in addition the 

 umbilic stump has been ligated, the entire functionless um- 

 bilic veins are distended with great masses of blood incar- 

 cerated by the ligature. The articular lesions consist chiefly 

 at first of intense synovitis with great distension of the 

 synovial sac. There follow later necrosis and erosions of 

 the articular cartilages, as shown in Figs. 233 and 234. The 

 synovia may be bloody and turbid, and may contain synovial 



