408 
AN ESSAY ON CHRONIC PODOTROCHOLITIS. 
by contiguity of substance, and this latter is found to be altered, 
although the disease has its original seat in the bone. The dis- 
ease never seems to arise in the trochlean cartilage : it is from 
sympathy only that this undergoes morbid alterations. It is the 
same with the tendon : this shews no disease until the portion of 
the bursal membrane which it covers becomes altered. 
The inflammation is confined for a considerable period to the 
trochlea, from which it extends, first, to the nervous and vascular 
ramifications situated beneath the navicular bone; afterwards, 
when the inflammatory action has attained a high degree of chro- 
nicity, it attacks the coffin bone ; but my own observations, agree- 
ing with those of Turner, lead me to conclude that the coronet bone 
ever remains intact. 
Podotrocholitis belongs, from its nature, to chronic inflamma- 
tions. Its progress is always extremely slow : it may last for 
weeks and months, and instances are by no means rare of its being 
prolonged for years. The termination is effected by resolution, or, 
what is unhappily more frequent, by the complete destruction of 
the trochlea of the foot. 
The seat and nature of the affection being thus, in a general 
manner, fixed, it is evident that the term lameness of the foot 
joint ( Hufgelenklcemhe ) is most equivocal, and ought to be rejected ; 
besides, this paraphrase does not point out the seat of the disease ; 
it places it in a portion of the articulation of the foot where it does 
not primitively exist ; lastly, it does not indicate the nature of it, 
but simply expresses one symptom. The same objections apply 
to the term podarthrocace used by Strieker*. I propose, there- 
fore, to call this affection chronic podotrocholitis, from nov; (gen. 
7ro$os) foot, trochlea , or pulley. 
Special Characters . — At the commencement of chronic po- 
dotrocholitis there is usually either inflammation of the bursal 
membrane only, or of that and the navicular. The superior 
portion of the bursa, which unites with the superior edge of 
the navicular bone and is contiguous to the tendon, presents 
on its internal surface a blush of redness, sometimes accom- 
panied with a slight tumefaction ; the portion which covers the 
trochlean cartilage, as well as the anterior surface of the tendon, 
has lost its pearly whiteness, and taken on a saffron-like hue, and 
this portion of the bursa is often thickened. The fluid which it 
contains is of a reddish colour, and much resembles the serum of 
the blood ; the coverings of those vessels which pass under the 
navicular are frequently injected. I have often seen the flexor 
tendon, close by its insertion into the coffin bone, present the ap- 
* Magasin fur die Gesammte Thierheilkunde, herausgegeben, von Dr. Gurlt 
und Dr. Hertwig. Vol. ii, part 1st. 
