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I owe her too much to write about her: tormented by pain and crippled by arthritis, she has shown a heroism and gaiety which command the love and respect of all who meet her. Of my other sister, Laura, I will write later. The boys of the family were different from the girls, though they all had charm and an excellent sense of humour.
Open navicular joint does not occur, as a rule, except by way of the solar surface of the foot, and the introduction of active and virulent contagium is certain to happen; consequently, an acute synovitis quickly resulting in an intensely septic and progressively destructive arthritis soon follows in perforation of the capsule of the distal interphalangeal articulation. Etiology and Occurrence.
Strangles or distemper is, according to most pathologists, due to the Streptococcus equi. Hoare states that in this type of specific arthritis the contagium is probably carried by the blood. He gives it as his opinion that even laminitis has occurred as a result of the streptococcus-equi. This, indeed, would point toward probable extension by the blood as well as by way of lymph vessels.
Circulatory stimulants also have been given, but it is doubtful if any good has come from medication. Fracture of Humerus. The shaft of the humerus, protected as it is by heavy muscles, is not frequently fractured; and fractures of its less protected parts, as for example, the head, are complicated in such manner that resultant arthritis soon constitutes the more serious condition.
A number of cases have been recorded in which arthritis deformans has followed upon antecedent disease of the joint, such as pyogenic or gonorrhœal synovitis, upon repeated hæmorrhages into the knee-joint in bleeders, and in unreduced dislocations in which a new joint has been established.
Otherwise she had no enemies; provoked no jealousy even among the plainest; neither gossip nor slander had ever been traced to her; she supplied the odd place at the Rector's or the Doctor's table at half an hour's notice; she was a sort of public aunt to very many small children of the village street, whose parents, while accepting everything, would have been swift to resent what they called 'patronage'; she served on the Village Nursing Committee as Miss Fowler's nominee when Miss Fowler was crippled by rheumatoid arthritis, and came out of six months' fortnightly meetings equally respected by all the cliques.
On the other hand, if a true arthritis is incited, there will be evident distress manifested, such as hurried respiration, accelerated pulse, inappetence, mixed lameness, local evidence of inflammation and particularly marked supersensitiveness of the affected parts.
Arthritis, for example, infects the blood and introduces into it scoriæ, a kind of refuse, of an imperfect organic combustion; but may not this very impurity happen to make the blood more stimulative? May not this impure blood promote a more active cerebration precisely because it is impure? Water that is chemically pure is undrinkable.
Of late years Raymond seldom let a week elapse without seeing Miss Ironsyde if only for half an hour. Her waning health occupied him on these occasions and, at his suggestion, she had gone to Bath to fight the arthritis that slowly gained upon her.
Wounds which affect the elbow joint, then, may be thought of in most cases, as resultant from external violence. They may be contused wounds or penetrant wounds. Sharp shoe-calks afford a means of infliction of penetrant wounds which may occasion open joint and infectious arthritis. Classification. A practical manner of classifying inflammation of the elbow is on an etiological basis.
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