if it be the hand of the owner, or some person who has the right to exercise government over them. They are a submissive and yielding race, wholly incapable of bearing malice on account of their degraded condition as slaves; and equally incapable of forming and maintaining, an effective and permanent organization among themselves, to assert their freedom, or to avenge their wrongs. They differ from their white masters in no one particular more than in this. Most of them, perhaps, desire their freedom, but when obtained, they know so little how to use it, and stand so much in need of the direction of the thinking and reflecting white man, as to become wretched and miserable, and often to desire a return to the state of slavery. Whether this be his rightful position in our country or not, an unprejudiced observer can hardly fail to arrive at the conclusion, that it is the one above all others, in which he enjoys the highest degree of health, the greatest happiness, and the longest life.-[Memphis Med. Recorder.

On White Swelling. By M. A. RICHET.

M. Richet believes that many erroneous ideas prevail respecting the pathology of articular diseases, which has been retarded by the uncertainty that has so long prevailed in respect to certain points of structural anatomy-as, e. g., the vascularity and nutrition of the cartilages, and their investment with synovial membrane. The microscope has now led to the solution of these questions, and, by availing himself of the results of its teaching, M. Richet believes that he can steer clear of many of the difficulties that beset the path of earlier pathologists. His own researches date some time back, he having published upon the subject of white swelling in 1844.

While approving the mode adopted by Brodie and Velpeau, of viewing these affections through the pathological changes they give rise to, he believes that they and other writers have not sufficiently followed the succession of these changes as they are observed in the different tissues. His object is to supply this deficiency, in showing that the different stages of the same chronic inflammation have been mistaken for special affections. He believes that all "white swellings" may be included under two fundamental varieties-viz., chronic inflammation of the synovial membrane and of the articular extremities of the bones. The changes which take place in the fibrous tissues are, as Brodie has advanced without demonstrating, always consecutive, while ulceration of the cartilages is not admitted by M. Richet. The synovitis, osteitis, or osteo-synovitis, may undergo modifications, by the constitution and temperament of the individual, or by the causes that have induced them, such modifications being of the more importance, inasmuch as they often affix a special seal to these affections, causing them to be regarded as distinct maladies.

The Pathological Anatomy of White Swelling, constituting the basis of the essay, is given in minute detail; but we are only able to glance at some of the more salient points. M. Richet has, during several years, taken every opportunity offered by cases of arthritis or experiments on animals, of tracing the progressive changes that take place in the synovial membrane. Between the fifth and twelfth day after irritation has occurred, a pseudo-membranous-like exuda. tion is effused from its surface, and becomes attached to granulations that are there more or less developed. When the chronic stage of synovitis arrives, these granulations may expel the false membrane covering them, and become themselves developed into fungous vegetations; or the pseudo-membrane may become more and more intimately united to the surface of the synovial membrane, undergo organization there, and prevent the farther development of the granulations. The two cases are respectively termed by the author-Fungous Synovitis, and Pseudo-Membranous Synovitis.

In Pseudo-Membranous Synovitis, layers of pseudo-membrane, intimately connected with vessels, unite the synovial membrane to the fibrous tissues of the joint; and when sufficient irritation is not induced to cause death or amputation, a natural cure_may take place through the agency of a fibrous transformation. Retraction ensues, and all the soft parts becoming closely applied around the ends of the bones, the joint then appears less than the opposite one. This form of synovitis is not infrequent after acute rheumatism, and it constitutes one of the varieties of incomplete anchylosis.

In Fungous Synovitis the granulations, in place of becoming organized, become, under the influence of a special diathesis (as e.g. the scrofulous,) cedematous and fungoid, and are, after different periods in different individuals, converted into reddish, softish vegetations, analogous to those which spring from carious bone. Containing some arterial vessels, they are chiefly made up of a venous network, in the midst of which is found a translucent jelly, exhibiting small spots like extravasated blood. The vegetations present an epithelial layer at their surface, and within, the fusiform fibres and elongated nuclei characteristic of fibro-plastic tissue. Brodie and other pathologists, from want of having sufficiently studied the alterations of the synovial membrane, have made of this a special affection, of a malignant nature. Occasionally, it becomes arrested in its course, a conversion of the fungosities into fibro-cellular tissue taking place, and a more or less complete anchylosis ensuing. In other cases, the fungosities become indurated, having cartilaginous plates diffused amidst their tissue. This induration is, however, only observed here and there, amidst the thickness of the changed synovial membrane, and gives rise to the development of irregular, so-called foreign, bodies, varying in size and density, being sometimes found loose in the joint, or only attached by a pedicle. Brodie admits primary ulceration of the synovial membrane; but the cases he adduces are too briefly narrated to justify the appella

tion. In M. Richet's opinion, the most frequent sources of ulceration are small centres of suppuration, met with in the altered synovial membrane, which, by breaking both externally and internally, establish sinuses, the extremities of which have all the characters of ulcers. The synovial membrane may also become ulcerated consecutively to the morbid changes taking place in it, while, when much distended with fluid, a sudden movement may cause its rupture.

The Fibrous Tissues are endowed with a very feeble vitality. The author's researches lead him to regard the ligaments as insensible, although, as their insertions into the bones are continuous with periosteal or osseous tissues, tearing or stretching these may cause pain. By no experiments has he been able to induce inflammatory action in the ligaments or capsule, even when the synovial was quite red, and the joint full of pus. When, in exceptional cases, they do become somewhat reddened, it is not the redness of inflammation, and it is almost always consecutive to lesions of surrounding tissues. One of the changes most frequently met with is a puffiness of the capsule and ligaments, produced by serous infiltration into the inter-fibrillary cellular tissue which separates the ligamentous fibres, these assuming, also, a dull tarnished appearance. This relaxation allows of great separation of the articular surfaces. At a later period, the fibrous parts become hypertrophied, or even indurated.

The Articular Extremities of the Bones.-M. Richet believing that, however well osteitis in general has been described by Gerdy and Miescher, the form that affects the spongy tissue in the vicinity of joints is imperfectly known, describes it, from his own observations, with a minuteness that defies our following him. It must suffice to say, that he admits three stages of primary osteitis. In the first of these, a section of the bore presents a vascular surface and enlargement of the cells, its compact surface being pierced with numerous minute holes for the passags of vessels. The secretions of the periosteum become diverted to the surface, and the bone is increased in size, in consequence of new layers deposited at its surface, as well as by the enlargement of its cells. Although such enlargement of bone is not admitted by Crowther, Russel, and S. Cooper, M. Richet has proved its existence by admeasurement, after separation of the soft parts. In primary osteitis, periosteal effusion is, however, not constant, occurring only as the inflammation approaches the surface; but in secondary osteitis, it is the earliest change observed. In the second stage, the red colour is concentrated at certain points, little collections of blood taking place. The cells become more and more spacious, and true abscesses are formed within the bone. Sometimes, however, hypertrophy of the intercellular parietes leads to a diminution in the size of the cells, and the spongy tissue is resistant instead of yielding. In the third stage, the pus which had been infiltrated into the cells destroys the

vessels, and the lamellæ, deprived of nutriment, become necrosed. At other times, ulceration, terminating in carics, occurs, and bleeding fungosities, or vegetating granulations, spring from the cells. Sometimes the cartilage is perforated only in places, at the bottom of which bleeding vegetations are seen, an appearance mistaken by Brodie and others for true ulcers.

Arrived at this stage, it is rare for the osteitis to be confined to the articular extremities, and, on cleaving the bone, the entire medullary canal is found to exhibit an intense redness throughout its entire extent, while small sanguineous effusions, and the other phenomena of the early stage of osteitis, are observed at the other extremity of the bone, although externally this exhibits no evidence of the change.

Consecutive Osteitis.-As synovitis may be secondary to an osteitis, so this last may supervene upon a synovitis. An osteo-periostitis so produced differs much from an osteitis properly so called, there not being the enlargement of the cells or the vivid injection of the spongy tissue, with its purulent infiltration. It is the periosteum which undergoes the chief alteration, the bone, at a later. period, undergoing hypertrophy even to its centre. It is, however, the cartilaginous surface that chiefly suffers, the synovial fungosities rapidly leading to its perforation and destruction, and entering into immediate relation to the bone. The compact lamellæ become necrosed, and the pus penetrates into the spongy tissue, inducing more or less deep-seated changes. Vegetations are often found within the cells; but beneath the fungosities the intercellular lamellæ are found more resistant than normal, while in primary ulcerative osteitis they are softened. Consecutive osteitis is a less refractory disease than the primary, the articular surfaces sometimes becoming covered with fibrous tissue that allows of some movement.

There is another change in the bone which, although not rare, has not been described, and to which M. Richet considers no better appellation can be at present applied than fatty degeneration. A few spoonfuls of a sero-sanguinolent or purulent fluid are found in the cavity of the joint, the synovial membrane not exhibiting changes proportionate to the symptoms observed during life. The articular cartilages are eroded, thinned and perforated by a great number of minute apertures. On raising them, which is easily done, a large layer of blood, having the colour and consistence of currant jelly, is found interposed between the spongy cells and the thinned compact lamella which is detached with the cartilage. On sawing the bone, in place of finding the cells more or less inflamed and gorged with blood and pus, the section presents a yellow color, deeper as the centre is approached. The cells are enlarged, and pressure by the finger produces slight crepitation, and expels a quantity of yellowish oily fluid. No trace of the smallest vessel can be found amidst the spongy tissue. The medullary canal is abundantly filled with this yellow fluid. The periostem is not in

flamed, no trace of the vascularity seen in osteitis existing, while the size of the bone is diminished rather than increased.

Changes in the Articular Cartilages.-M. Richet regards cartilage as possessing a very rudimentary organization, coming between fibro-cartilage and the products of epidermic secretion. Its mode of life is, as it were, parasitical, living by absorption of the liquids amidst which it is placed, its component utricles or cells operating osmosis. To the question, whether the articular cartilages are susceptible of inflammation, and of participation in the diseases of surrounding parts, M. Richet replies in the negative. By no experiments can vascularity be induced, and no attempts at reparation are found after old injuries. Amidst the completest change in surrounding parts, they exhibit only some roughening or thinning from commencing absorption. Vascularity, supposed to have been seen on their surface, is really due to the development of new vessels in a pseudo-membrane that covers them. Ossification, adduced as a proof of vitality, is never found in the case of true cartilage; but the eburnation of the bony extremities, after the cartilage has disappeared, has been confounded sometimes with this.

The articular cartilages are, however, liable to various kinds of alterations, resulting from perversion of their nutrition, or from mechanical or chemical causes. Among such is a loss of elasticity, noticed by Delpech, and frequently observed by the author. Ramollissement, which appears to be another stage of this loss of elasticity, occurs also pretty frequently, especially in those who have died in advanced years. This change, which has by others been termed velvety, has been the object of much research by M. Richet since 1840, and he thinks there is always coincident with it a diminution of synovia, probably due to a lessened nutritive activity in the bones and articular secretions. A total or partial disappearance of the cartilages seems to be a third stage of these alterations, which, while they cannot be called normal, can yet hardly be described as pathological, as they are met with in persons whose joints were healthy.

As regards the changes in the cartilages of diseased joints, they are due either to loss of cohesion-ramollissement-or are characterized by thinning, inequalities, or erosions. The last especially claim attention, as by some authors they have been termed ulcerations. When the cartilage is found roughened and unequal, this is due either to wearing away or resorption exerted at certain points, to a perversion of nutrition due to disease of the bone, or to the presence of abnormal fluid within the joint. As the cartilages live at the expense of the parts which surround and support them, they become more or less changed, according to the duration and severity of the disease of the part.

When we examine a joint that has suffered from white swelling, originating in osteitis or advanced synovitis, we almost always find the appearance as if the cartilage had been irregularly punched