DISEASE 0F T/IE Ihr-JoiNT. Hip-disease differs in so many points of importance from other joint-diseases, and is so serious an affection, that it requires a special notice. Its connection i with scrofula is more distinctly marked than that of most other joint diseases, and t almost always occurs before the age of puberty. It comes on, in children or young persons of a scrofulous constitution, from very slight causes; thus, it is often traced to over-exertion in a long walk, a sprain iu jumping, or a fall ; and in many cases no apparent cause can be assigned.
In the early stage of the disease the whole of the structures of the joint are inflamed, and by proper treatment at this period the morbid action may be sometimes subdued without any worse consequences than a more or less rigid joint. Usually, however, abscesses form around the joint., and often communicate with its interior; and the acetabolum, and the head and neck of the thigh-bone, become disintegrated, softened, and gritty. In a still more advanced stage. dislocation of the head of the thigh-bone commonly occurs, either from the capsular ligament becoming more or less destroyed, and the head of the bone being drawn out of its cavity by the action of the surround ing muscles, or from a fungous mass sprouting up from the bottom of the cavity, and pushing the head of the bone before it.
It is of extreme importance that the symptoms shOuld he detected in an early stage of the disease; and on the least suspicion of this joint being affected, surgical aid should at once be sought.
As the disease advances, abscesses (as already mentioned) occur around the joint, which sometimes, from the tension they exert on the obturato• nerve, occasion extreme pain in the inside of the thigh. True shortening of the limb now takes place, which at the same time becomes adducted and inverted. From this stage, if the health is pretty good, and the lungs are sound, the patient may be so fortunate as to recover with an anehylosed (or immovable) hip-joint ; but the probability is that exhaustion and hectic will come on, and that death will supervene, front the wasting influence of the purulent discharges occasioned by the diseased bone.
The duration of the disease may vary from two or three months to ten or more years.
As the treatment must be left entirely in the hands of the surgeon, it is unnecessary to say more than that the most important points are perfect rest to the affected part, which may be secured by a strong leather splint, or by a starch bandage, the internal administration of cod-liver oil anti tonics, and the application of counter-irritation by means of an issue behind the great trochanter.