Excerpt from Encyclopaedia Medica, Vol. 6: Joints to Liver Tuberculous diseases result from bacillary infection of the synovial membrane, or of the marrow of one or other of the adjacent bones. The infection occurs under similar conditions to those which have been already described in diseases of Bone (vide vol. The tuberculous lesions of joints, although having a common origin in infection with the tubercle bacillus, differ widely in their anatomical and clinical features. From the anatomical point of View they may be divided into those in which the disease originates in the synovial membrane and those which originate in disease of one or other of the adjacent bones. The relative frequency of these two types has been variously estimated. The sources of disagreement are to be found in the difficulty in distinguish ing them from one another, and in the fact that only the more serious and more advanced forms of the disease are subjected to operation; the milder forms of primary disease in the synovial membrane so commonly recover without operation that they do not figure in the records upon which the estimate of the relative frequency is based. It is probable that the frequency of primary disease in the bone has been exaggerated, Krause, for example, estimates the proportion observed in Volkmann's clinique as 23 per cent of synovial origin to 77 per cent originating in the bones. The relative frequency varies with the age of the patient and with the joint affected; in children, the number of cases originating in the bones is approximately that given by Krause; on the other hand, primary disease In the synovial membrane is relatively more frequent in adults. The predominance of bone lesions in childhood and youth is to be ascribed to the conditions associated with the growth of the skeleton, especially at the ends of the long bones. As regards the joint affected, the maximum frequency of osseous lesions is found in the hip (26 synovial to 129 osseous, Krause); the proportion is about equal in the case of the knee (266 synovial to 281 osseous, Konig), and probably also in the case of the elbow, wrist, shoulder, and ankle. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.