136 
PATHOLOGY OF ST11INGHALT. 
(C One word more respecting articular cartilage, for it is 
tliis variety which the doctor refers to when alluding to its 
extreme sensibility when inflamed.” I alluded to cartilage 
only in a general way; I certainly did not wish to be under¬ 
stood as stating that the cartilage w as primarily ulcerated, or 
that it is sensitive, or that vessels can be traced into it when 
in a healthy condition; it is, nevertheless, subject to disease— 
call that disease inflammation, ulceration, degeneration, dis¬ 
integration, liquefaction, or any other name you please. 
While fully appreciating the investigations of histologists, 
I must confess I am not yet willing to drop the substance for 
the shadow. Cooper, Liston, Brodie, Guthrie, and others, 
hesitate not to state that cartilage plays a conspicuous part 
in diseases of the joints, increasing pain as it is more or less 
involved in disease. Kolliker, a sound histologist, states that 
blood-vessels have been observed in it up to the eighteenth 
year; Brodie and Liston have likewise traced vessels into it. 
I cannot divest my mind of the existence of vessels in car¬ 
tilage ; to do so, I should have to consider it inorganic, which 
I do not. I believe it must be supplied with vessels of some 
kind for its nourishment, and for its repair wdien diseased; 
and I also believe that wherever blood-vessels go, nerves will 
be found to accompany them. 
Of all the tissues in the body, cartilage possesses the lowest 
possible degree of vitality, and herein lies its great value. It 
is owing to this fact that it is able to resist violent con¬ 
cussion and injuries, to which it is at all times liable; and 
for the same reason, wdien ulcerated or diseased, its destruc¬ 
tion or decay is very slow. But admitting, for the sake of 
argument, its non-vascularity, this would not alter the fact 
that it is subject to inflammation. 
Since my letter was written to the Spirit of the Times I 
have obtained a work on diseases of the joints, published in 
1861, by Barwell, a good histologist and an excellent sur¬ 
geon. He says, “ It can now be certainly affirmed that any 
part which is capable of nutrition is also capable of inflam¬ 
mation ; it can, I submit, be no longer denied that cartilage 
is liable to be inflamed, and consequently ulcerated.” Again, 
“ Cartilaginous inflammation is accompanied by a liypenemia 
of the vessels; it is certain that what is called vascularity of 
tissue is not necessary to confer on it a pow r er of becoming 
inflamed; it is equally certain that wffien a tissue makes in¬ 
creased nutritic demands, increased supply will be brought to 
it.” Again, “ One of the circumstances in this disease which 
is most remarkable, and which has the greatest effect upon its 
subsequent course^ is its constant accompaniment —the spas - 
