When the patient stands, the affected limb is considerably advanced before the other, on which the weight of the trunk is chiefly, or entirely, supported; the knee is generally bent, and the toes only rest on the ground. In the advanced stages of the disease, and when there is reason to suppose that ulceration of the cartilages has set in, the patient, during progression, moves the affected limb with the hands grasped round the thigh, and in bed it is moved by the aid of the sound one. The spine is frequently affected, becoming bent in different directions, to preserve the equilibrium of the body; and a deformity of the trunk to a certain degree occurs, which, however, may be in general easily remedied. The nates are much altered; they become flattened, and those parts which are naturally most prominent are reduced to the level of the others; the usual niche between the buttock and thigh, in the erect position, is effaced, and the upper part of the thigh is often considerably swollen. The alteration is at once manifest on contrasting the healthy with the diseased side. Even from the first, locomotion is difficult: in the morning, the movements of the joint are constrained and stiff; afterwards, however, the patient walks with more ease, though still by very slight exertion the limb is speedily tired, and he is unwilling to use it. Pain is produced by pressing on the groin, or by tapping on the trochanter, and by pushing the head of the femur forcibly against the acetabulum. The inguinal glands occasionally become enlarged. As the disease advances, the lameness is more apparent; pain is produced and increased by motion, and by any attempt to stretch, and more especially to abduct the limb whilst in the recumbent posture. The emaciation of the member becomes more and more visible. The muscles, as it were, are paralysed from inaction and pain, abscesses form, and the constitution then sympathises remarkably; hectic fever supervenes, with its usual train of symptoms. [Illustration]