Book Description

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1843 edition. Excerpt: ...of soda or ammonia and phosphate of lime (tophaceous matter) secreted within and around the articulation. This crepitation is a sure indication of imminent complete ankylosis. The articulations of the fingers are equally liable to ankylosis from the causes here mentioned, and the deformity produced in them by gout is very considerable. Occasionally the cretaceous matter is so abundant, that the superincumbent skin yields to the pressure exercised from within outwardly, is slowly removed by absorption, rarely with ulceration. By these means the cretaceous matter is thrown out, constituting "chalk stones." The interior of the articulation may then communicate with the external atmosphere; but in consequence of the changes previously effected in the synovial membrane, the usual destructive results of exposure of the interior of an articulation do not occur. Treatment.--If the ankylosis have arisen from accident or phlegmonous inflammation, or if the cause have been struma, the case being complicated by the cicatrices of fistulas in different situations among the carpal bones, and complete immobility exist, it may be considered incurable. But in several cases of incipient calcareous adhesion of the articular surfaces from "rheumatic gout," or where sufficient tophaceous matter has been secreted around the articulation, so as firmly to encase it, all appearance of inflammation having subsided, I have been enabled, even where complete immobility existed, to restore the functions of the part. Frictions, manipulations, baths, the internal administration of iodide of potassium, and attention to the functions of the liver and kidneys, have been the remedies employed. These cases have proved to me the possibility of absorption of...