American practice of surgery - a complete system of the science and art of surgery (1906) (14782077492)

Identifier: americanpractice03brya (find matches)
Title: American practice of surgery : a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914 Buck, Albert H. (Albert Henry), 1842-1922
Subjects:
Publisher: New York : W. Wood and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive



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or View of the Same Case. (Original.) nantyne and Wohlman described an organism which they had succeeded inisolating from joints, and which they claimed was the specific cause of the jointinflammation in question. Their organism was different from Schuelers, butboth observers obtained an organism with constant morphological character- NON-TUBERCULOUS INFLAMMATIONS OF JOINTS. 529 istics in all their cases. In the light of the work which has been done on in-fectious processes in joints in recent years it would seem that such variabilityin the characteristics of the bacteriologic findings was exactly what might beexpected when one recognizes the fact that many bacteria may be the causeof intra-articular tissue changes very similar to those which are the subject ofthis discussion. Furthermore, there seems to be no doubt that, even whenbacteria themselves cannot be demonstrated either in the fluid of the joint oron examination of the tissues which line the joint, we are justified, from the
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Fig. 236.—Shows the Overgrowth of the Cartilage in the Terminal Phalanges Characteristic ofthe Formation of Heberdens nodes. (Original.) character of the tissue changes produced, in inferring the action of some toxinswhich possibly have been absorbed from a remote focus. That there is anyspecific bacillus, as claimed by Schueler and Wohlman, for this condition, is astatement which, in view of the later investigations, seems to lack confirmation.In syphilis the writer has seen as pronounced villous changes in the capsule ofthe joint as were ever observed in any of the more acute infections, and thiswas in the stage just preceding the disintegration of the knee joint fromCharcots disease. Bacteriologically, no organisms were demonstrable in thetissues. From purely traumatic causes, particularly when the trauma is aninternal one, we may get extensive, local, villous changes in the synovial mem- vol. nr.—34 530 AMERICAN PRACTICE OF SURGERY. brane entirely dissociated from any bacteria