It has been already observed (at page 68), that the cartilages are
occasionally swelled and softened in cases of chronic inflammation; and
it now remains to notice instances in which they become hypertrophied
or atrophied, apparently without inflammatory action. Although these
affections are not likely to come often under the treatment of the
surgeon in civil life, yet they are of much importance to the naval or
military practitioner, since an accurate knowledge of them will lead
him to institute a careful inquiry when a man complains of inability to
sustain the fatigue of marching with the burden of a heavy knapsack;
and they are of considerable interest in a physiological point of view,
because they tend to show the inherent vitality of cartilage, and that
it is liable to serious organic changes quite independently of diseased
action in the surrounding tissues.
Some examples of hypertrophy of cartilage, principally affecting that
of the patella, have been described by Mr. Gulliver, and figured in the
third fasciculus of drawings from the Army Anatomical Museum. In these
the cartilage is swelled so as to form a ridge across the articular
surface of the bone, the hypertrophied part being perfectly smooth,
except where its continuity is interrupted by irregular fissures, as
if the perpendicular cartilaginous fibres were split into bundles of
variable size and shape. These cases occurred in young and middle-aged
men who died of pulmonary consumption; and it is probable that the
disease would be more frequently found, if it were more frequently
looked for, since it does not seem to have been accompanied by any
change in the surrounding parts, and would perhaps only be indicated by
weakness of a joint rendering it unfit for severe work.
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