JOINTS

are the junctions of two or more bones. In some the junction is effected by the one bone fitting immovably into the other, as in the skull. In others a layer of gristle intervenes, as in the joint between one vertebra and the next. [In yet others free movement is — the bones being only united by ligaments and muscles. The ball and socket joint like the shoulder, the hinge joint like the knes, and the pivot joint like that of the atlas on the axis, are examples of joints permitting free movement in one or more directions. The friction such movement causes is reduced by the accretion within the joint of a oo lubricating fluid known as the synovial fluid, and also by the ends of the bones being covered with emooth gristle or cartilage; whilst in certain places epecia! extra oo of gristle are so placed as to form buffers between bones and thus le en concu ion. These pad a at times may become dotached, and being then loose in the joint they become nipped between the bones. Such an accident causes great pain with defective movement of the joint. It is most common in the knee-joint, and forms the most common accident on the football field. The chief diseases from which joints suffer are inflammation caused by injury, gout, rheumatiem, rheumatoid arthritis, dysentery, gonorrhw@a and tubercuiosis. Inflammation is accompanied by eels due largely to an exce of synovial fluid, but after a wound the swelling may be due to matter. The chronic inflammation of tho joint caused by tuberculusis produces “ white swelling,” owing to the dis organ i a at i on of the interior of the joint by the growth of new ti ue. Later, this ti uc, which is deficient in blood-ve els, breaks down into dead liquid material like matter. The treatment of joint discase varies with tho cause. An acute injury or inflammation requires absolute reset, but gentle movement must not be delayed too long or atiffne results. Chronic joint trouble may require prolonged rest, as in tuberculosis, but more often hot bath treatment, followed by ma age, such as Bath, Buxton, Droitwich and gi the Continental Spas provide, are the most suitable. e local ay a of heat may also be effected by bags of sand or salt heated in the oven, and of recent years the “ Dowsing System” has come to tho front. In this mode of treatment the joint is enclosed in & motal case containing o a number of electric lamps, the heat and tight from which act on the joint. Stiffne of the Sy owing to the formation of adhesions within them, is s common result of chronic inflammation. If movement cannot be regained by hot baths and ma age, it may be nece ary forcibly to bend the joint under ao anesthetic and to apply movement and ma age subseuently. In tuberculosis arrest of the disease, with a etiff joint, is often the best result that can be hoped for; henco the indiscriminate bending of all stiff joints is fraught with danger. The “ bone-setter” is in the habit of stating that all joints shown to hin: are “out,” and he then treats them read and sudden bending. Adbesions are thus en down and movement re-established. By breaking the crutches he insures the movement being continucd. In certain cases ho thus achieves a great reputation, at tho Cost of infinite harm to those in whom jek violent treatment is the exact opposite of that which is required. [s. 380]