When bone is extensively affected with inflammation, motion is
impaired; the muscles being displaced and retarded in their action by
the swelling and irregularity of the bone, by effusion of lymph into
their tissue and intermuscular spaces, and, perhaps, also, by their
partaking, in some measure, of the inflammatory action. Any attempt
to move the parts very much aggravates the patient’s suffering.
Occasionally inflammation attacks almost all the bones in the body,
and causes great constitutional disturbance, by exhausting the powers
of life: it sometimes terminates fatally. Bones become inflamed from
various causes. However it originates, the action ends, as in the other
tissues, in resolution, suppuration, or mortification. The effusion
by which the diseased vessels naturally relieve themselves in softer
textures cannot here take place so readily, or to such an extent as
to prove beneficial: the intensity of the action is with difficulty
subdued, and, consequently, resolution is comparatively rare. When it
does occur, the parts do not soon regain their natural condition, but
often remain considerably swollen and indurated, as is seen in nodes,
which continue during the life of the patient, without causing pain or
much inconvenience.
Suppuration on the surface, or in the centre, and partial or total
death of a portion of bone are the most frequent consequences of
external injury and incited vascular action; but suppuration in the
cancellated texture frequently follows very slight incited action
in those of a scrofulous habit. Tubercular matter exists, in all
probability, previously, and it leads very often to long continued
disease, curable only by operation. The matter may find its way to the
surface after long suffering and great constitutional disturbance.
Again, it may be confined for months, or even years, the patient
suffering from time to time the most excruciating agony. The bone
becomes thickened towards the surface by new deposit, as the cavity
is increased by ulcerative absorption, and relief is only afforded, a
correct diagnosis having been formed, by artificial evacuation of the
matter. In many cases small sequestra lie in the cavity; and though
the matter escapes naturally, or is evacuated, the patient’s strength
becomes worn out, and he perishes, unless the limb is removed. So
long as dead portions of bone remain, the discharge cannot cease
permanently. Fresh collections are apt to form in the soft parts if
the original openings close. It is no easy matter to discover or
remove sequestra from deeply seated bones. A section of the femur is
represented on the next page, showing a cloaca leading to the cavity
of an abscess in the medullary canal. The bone is very dense in
consistence, and irregular on its surface.
[Illustration]
Public-domain text, read in full here on John Shaqi.
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