of the structure and diseases of articulating cartilages, by william hunter, surgeon

Of the Structure and Diseases of Articulating Cartilages, by William Hunter, SurgeonAuthor(s): William HunterSource: Philosophical Transactions (1683-1775), Vol. 42 (1742 - 1743), pp. 514-521Published by: The Royal SocietyStable URL: http://www.jstor.org/stable/104206 .

Accessed: 14/05/2014 20:57

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at .http://www.jstor.org/page/info/about/policies/terms.jsp

.JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range ofcontent in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new formsof scholarship. For more information about JSTOR, please contact [email protected].

.

The Royal Society is collaborating with JSTOR to digitize, preserve and extend access to PhilosophicalTransactions (1683-1775).

http://www.jstor.org

This content downloaded from 194.29.185.150 on Wed, 14 May 2014 20:57:03 PMAll use subject to JSTOR Terms and Conditions

http://www.jstor.org/action/showPublisher?publisherCode=rsl

http://www.jstor.org/stable/104206?origin=JSTOR-pdf

http://www.jstor.org/page/info/about/policies/terms.jsp


c c

[Me] r52. [Me] r52.

- - A >x A >x -.h;# -.h;# 51 51

D D

<X. 2* r 55z <X. 2* r 55z

A A wrv D- -

-

wrv D- -

-

f f

- . -

F - . -

F iB /' '

^-d

iB /' ' ^-d

A A

A A

t I)

. t I)

. ;. flil=

-' " ' ''4_,,4

;. flil=

-' " ' ''4_,,4



t 514 j

vr. of the Strudglre vxd DiJ2+s ef Artics- lati7g Cartilages, b William Hunter, Ar- geon.

ReadJune 2. H E Fabric of tlle Joints ill thc 1743 1 Human Body is a Sub jedc So much the alore entertaininga as it muA firike es?ery olle that confiders it attcntively nvith an Idca of fine ncclla- nical CompoStion. Wllerc evcr tllC Motion of OllC Bone 1lpon anotller is rcqui(ite, therc we find an ex- cellent Apparatus fbr rendering that Motion fafe and frec: We lee, fbr InRanceX tlle Extrenlity of one P;one moulded into an orbicular Cavity, tO receive tllc Head of another, ln order to affbrd it an extenfive 1'lay. Both are covered nvitll a fmooth elaRicCruil;, tO prevent mutual Abralion; conneded with firong Ligaments, to prevent Dinocation; and illclofed in a Bag tilat contains a proper Flllid depofited there, for lubricatinr the Tsro contiguous Surfices. So much n genera .

But if Curiofity lead us a Stcp fiartller, to examine the Peculiarities of ea¢Il Articulation, wre meer Wittl a Variety of Compofition casculated tO al; the Varie- ties of Motion requte in tlle t!uman Body. Is tlle MOtioll tO be f^ee and exrelzfive i one Place ? Therc we filzd rile xvilole Apparatus conttiv^ed accordingly 6vIght 1t tO be tncre confilled in anotller ? Here we flnd ito Iluppily limited. ln {hort} as Natures Inten- tioias ax4e sarioals, her \\torkwlanflip is varied accord AnO Y

Tlucfic



[ sls ] Thefe are obvious ReflcEtions, andX perhaps, as o1d

as the InrpeEtion of dead 13odies. But naodern Ana- tomiRs have gone firther: They lwave brougllt tl1e Articulations) as well as the other Parts of tl1e 13odyX tInder a narrow Inquiry, and entcrcd into thc mintltc(t Parts of their Cotnpofition. The Boncs llavc becll traced Fil)re aftcr Fibre; but the Cartilages} as far as I can learn} have not llitherto becn XfEciently cxS plained. AfEer fome fFuitleEs Attempts by macerating and boilin^, tlle Cartilages in different Mengr;Za-;> I fill upon tlae Method not oly of bringil1¢ tilCi}s

fibrous Texture to Vicw} but of tracing the DircE:txon and Arrang;etnent of tllc:>6e Fibres. I nlall tlacrcXrc endeavour tO give a nlort Account of the StruEtllrc of articulating Cartilages, and make a fesr Oltfcrva tions on their DiSea{Us} xnrith a vieBr to adstancc a rational Explication of their nlorbid 'Phomen.

An articulating Cartilage is an elallic SubPlallce unibrmly compadt, of a xvhite Colour} and fomewl1ae diaphanous, having a fmooth poliffied Surfice cosered with a Membrane; harder and morc brittle vllan a IFiDament} foffer and rnore pliable than a 13onc -

MJhen all articulating Cartilage is svcll prepared, t feels Sofi} yields to theTouch} bttt rcllores itSclf tO

it5 fbrmer Equality of Surfice wi1en rllc PreStre iq taken off. This Surfice, when sicwed tllrough a GlaS, appears like a Piece of Velxct. If we ell dCaYOUr tO peel the Cartilage off in LxZe } ws c find it impradicablc; buta if we uk a ccrtain dcrrec of Force) it feparates fFolzl tlle Bone in fmall Parcelsa and xve never find tlle Edge of the remaining Part obliquea but always perpendicular to the fubiacent Sllrfice of the Bone. If we vlew this Edge throuC,l

Xxx X a



[ 116 ] a GlaSs, it appcars like the Edge of velYet; a MaSs of Ihort and nearly purallel Fibres riFing .fronz the Bone, and tcrminating at the external Surface of the Cartilage: And ehe Bone itrelf is planned OUt into fmall circular t)imples, where tlle littlc Bundles o£ the cartilaginous Fibres were fixed. Tllus we may cotnpare the Texture of a Cartilage to the Pile of Velvet, its Flbres rifing up fieonz thc Ilones as the filky Tllreads of that rife from the wovell Clotl:z or Bafs. Ill botll Subftances tlle Ihort Threads fink and bend in Wavcs upon being compreSed; but, by the Ponvcr of Elalllcity, recover their perpendicul-ar Bearing, as fOQN as tlley are no longer fubjeded to a ccznaprelElng Force. If another Comparifon was eceIlary, xve might inflance the Flower of any corvmbiferous Plant whcre tlle FloJ^agli and Sta- mina reprefent the little Bundles of caltilaginous F'bres > and the CoFlyx, upon which they are planted, bears Allalogy tO the ISone.

- No\^r tlaefe perpcndicular Fibres make tlle greateA Part of tlle cartilaginous Subftance; but without I)oubt there are likewife traaDvcrfe Fibrils which conP necrt them, and rnake the \Mhole a folid Body, though txzeSe laR are not eaEly fcen, becauSe bcing very tcndcr, they are deRroycd in preparing the Car- 2ilage.-

\Ve are to)d by Anatonzifls9 tllat Cartilages are co>crcd nvith a lMeml)ratle named 'Periahondrigm 1tv they naean t1<e Cartilages of the Ribs, Larynx, Ear, w. there, indeed} fllcl1 a Melnbrane is vcry e:onlpicuolls ; but tlle 'Periahondri^n of the fmooth articulatint CAttilagCS iS fo fine, and firmly braced llpOLl the Sarfa<e, {llAt tllere is room to doubt whc-

tCle



[ $17 3

ther it 11as been often demonltrated, or rightly under- Rood. Tllis Men-brane, howcvel4, I have raiSed in ptetty largc Pieccs aftcr macerating; and find it to be a Continuation of that finc, Emootll Membrane that lines tllc capfular Ligamcnt, folded over thc Enct of theBonc from wherc tlat IJigalncnt is inferted. On the Neck of tlle Bone, or betwccn the Infcrtion of tlle Ligament, and Bordcr of the Cartilage, it is very confpicuous, and may be pulled up Witll a Pair of Pincers; but where lt coYers the Cartilage, it coheres to it fO cloSely, tllat it is not to be traced in the recent Subjedc without grcat Care and Delicacy. In this Particular lt reSembles that Membrane which is commo£w to the Eye-lids and thc Fore-part of the Eye-ball, and which is looSely conncEted with tlle

S16gggineaX but firongly attached to the Cornea. From tlliS Dcfcription it is plain, tl<at every Joint

is inveLted with a Membrarle, which forms a com- plete Bag, and gives a Covering to evcry tlling writllin the Articulation, in the fame Manner as thc iCeritons¢m inveRs not only thc CParietes, but tllC

Contents of the S;domen. The Blood-veffiels are fio Em-all, that they do not

admit the red Globules of the Blood; rO that tlley remained in a great meaIure unknown, till the Art of filling tlue varcular SyJflenl witll a liquid Wax brouglat them to Light. Ntor even by this Metllod are we able, in adult Subjeflts, to demonArate tlle VeXels-of the true cartilaginous SubRance; the Fat, Glands, atld Ligarl-zents, thall bc red x^tith injeEted Veliels, wlaile SlOt ODC colollred Speck appears UpOll

the Cartllage itSelf. In very young SubjeEts, after a filbtle Ine£tiol> tlley are vcry obvious; axqd 1 have

found



- C Sl8 3 found tlletr Courfe to bc as follows: All round the Neck of tluc 13onc there are a great Numbcr of Artcries and Yeins, wllich ramify into fmaller Branchcs, and comlnunicate witll orle another by frequent SnaJ?omo/es, like thofe of the Mcfcntcly. W^llis mi^,ht be called tlle Cirr?las JrticBli Zafic- lolgs, the vaScular Border of the Joint. The finall }3ranches divide into llill fmaller ones upon tlle adjoining Surface, in tllcir Progrefs towards tlle Centre of the Cartilage. We are very feldom able to trace them into its SubItance, becaufe they tcr- minate abruptly at the Edge of the Cartilage, like the VeXels on the SIbBginea Or?zli wherl they comc to tlle Corne. The larger VeXcls, which compoSe tlue vaCcular Circle, p]unge in by a great Numbcr of fmall Holes, and dirperfe themfelves into Branches betnveen the Cartilage and Bone. From thefe again there ariSes a Crop of fmall {hort Twigs, that {hoor towards the outer Surface; and whether they fiervc for nourilhing only, or if they pour out a dewy Fluid, I {hall not pretend to determine. However that bc, I cannot llelp ol)Servirlg, tllae the DiRribu- tiorl of tlle Blood-veXels to tlle articulating Cartila^,es is very peculiar, and feems calculated for obviating great Inconvexiences. Had they l^un on tlae outer Surface, the PrelEure and Motion of the Two Carti Sages muR infallibly llasc occafioned frequent Ob fir}2ions, Inflammations, eir. which vould foon have rendered our Motions painful, alld at laflc intirely deprived us of them. Btlt by creeping round the cartilaginous Brim, wllexe tllere is little FriEtion or under the Cartilage, where there is none, tlley are perfe&xSy weil defended from fuch AccidentsO

1;



[ 519] It xveve to be wilhcd sx?e could trace the Nelves

of C>ltilages: But, itl relation to tllefie. Organs, heres as in many other Parts of tlle Body, sre are under a NecelElty, from the Inzperfcdrion of our Senfes, of lJeing fatisfied with mere Con jeEture And tlaoughX irom the great InSenfibility of a Cartilage) fiome llave doubted of itS being furni Dhed Witll Nerves ; yet, as it is generally allouTed, that thefie are a rne qua non in the Grosvth and NourilEment of Animals, we have no fufficient Reafon tO deny tlueir ExiPrence in this particular Part. With regard to the mallner of tlleir DiRribution, we may prefume, fiom Analogy, that they follonv the fame CourSe svith the Blood-veXels.

The articulating CalZtilages are moR happily conw trived to all Parpofes of Motion in thofe Parts. By their uniform Surface, they move upon one another xvith Eafe: By their foft, fnzooth, and {lippery Sur- face, mutual AbleaSwon is prevented: By eheir Flexi- bility, the contiguous Surfaces are confiantly adapted to each other, and the Fridion diffuSed equally ovcr the Whole: By their ElaRicity, the Violence df any Shock, which may happen in running, jumping, eSr. is broken and gradually fp-ent; which muR have been extremely pernicious, if the hard Surfaces of Bones had been immediately contiguous. As the Courfe of the caltilaginous Fllore$ appears calculated chiefly for this laR Adsantlge, to illuRrate it, wc need only r<fleEt upcBn the yoft tIndulatory Motioru of Coaciles, xstIzicil Mechanics svarlt to procure by Springs; or upon the DiScrcnce betwixt riding a ChamberHolf: and a real orue. to concl tld e, tlle In fenfibili ty of articulating Caltilages is wifely contxived, as by tlwis

means



[ S20 3 means the neceCary blotions of the Body are per form-ed without Paine

If we collfult the Randard Chirurgical Writers fom Hipporrvzes down to the prefient Age} sve ffiall find, that art uIcerated Cartilage is univerfally allowed tQ be a very troubleCome DiSeaSe; that it adnzits of a Gure with more Difficulty than a cariolls Bone; and tbat, nvhen de-flroyed, it iS never recovered. Hildangs3 in confider ing the fe D ifieaGes, has cabferved , that xaihen the Cartilages of a Joint were dePtroyed, the Bones cczmmonly thresr OUt a cementing Callgs X and thus a .bony SnaXyzofs, or immoveable Continuity, was formed where the moveable Joint had been. So fix as I have had Opportllnities of examining difeaCed oints, either after Death or Amputation, I hasre found, according to the Nature and Stage of the DiSeafe, the Cartilages in Sorne Parts reelilh and lax; or foft and fpongy; or raiSed up in Blillers from the Bone; or quite-croded, and, perhaps, the Extremities c3f the Bones carious; or, laPtly a bony SnaXyl formed. But I could never Sc.e, nor indeed hear of, the leaPr Appearance of an Exfoliation firom the Surface of the Cartilat,e. P{-ow, if we compare the Texture and morbid sPhnomexa of thoSe Cartilages together, a11 the difeared Appearances will admit of as rational a Soluiion, as pvethaps any other Part of -the vltlated Oeconomy.

It appears from Mac.eration, that the tranfrerSe F;ibrils are extremely tender and diXoluble; and that the Cohefion of the Parts of the firait Fitbres is fironger than their Cohefon with the Bone When a -Carv tilage thexefose is inflamcd} and foaked in purulcnt

Matter,



Matter, the tranfsterfe or conne&;ng Fibres will tlle fooncR ,ive way) and tlle Cartilage l)ecomes nzore or leI; red and toft, eS. If the DiSorder goes on a lictle longer) the Cartilage does not throw off a SloughX but Separates from the Bone, wllere tlle Force of Cohefion is leaflc, and where tlue DifeaX foon arrives, by reafotl of the Thinnefs of the Car- tilage. When the Bone is thals expoSedX tlle MattclO of the Ulcer} or Motion of the Joint, cor1odes olt abrades tlae bony Fibres. If tlle Collfiitution is good theSe will oot fortll a Callas; szrhich eitller cemellts the oppofite Bones of tllC Articulation, or fills *lp tlac Cavity of the Joint, and for tlle fueure prevents Mos tion. But if, unfortunately, the Patient labours undcr a bad Habit of Body, the Malignancy, 11aving gQL Root in the Bone, xvill daily gaill grotlnd, tlle (v5aa ries will Epread, and at laPc the unhappy Perfon lllUR fubmit to Extirpation, a doubtful Rclmedy) <3r x?cat out a painfill, though probably a fhott Lif¢.

EXP1iCation Of tlle F I G U R E. P;gUrC I. TAB. IV. Reprdents a View of the Patclla

on the BavkJ4de, where it is overed with a jnooth Cartilage. In this we may obJ^erseX

A A A A. Se Sgrface of the Cartilage, appevrags {when the Pericllondrium is remo7ved, like VelqJer. lElear the MiddZe, 23art of the Cartilage is tak¢7s oxt, in order to Jbe^zv

B. Ehe fiX6jaatnt Sgrface of the Bone: Snd C. IRhe Ihiaknefrs of the Carnlage, where the per

pendixlar Fibres are feeg xvery di/EnAly. D. F^hercabross lower iFount of this Bone} ixto wkrh

the Ligament is inHerted that birgds it to the Tibia Y y y VII Part



of the structure and diseases of articulating cartilages, by william hunter, surgeon

Documents