L'Encyclopédie internationale de chirurgie, un traité systématique sur la théorie et la pratique de la chirurgie de l'ataxie, l'od . Le patient * Buzzard, Transactions pathologique, vol. xxxi. p. 2G8. Qaz. des hôpitaux. Loc. cit. 428 MALADIES DES ARTICULATIONS, se réveille avec une jambe enflée considérablement, l'élargissement étant la plus marquée au niveau de l'AIIO avec le programme commun, où il est aussi aidematous fluctuathig ou plus clairement ; l'ncighbtn-iiig parties sont plus intense, et seulement à l'pressurewith tinger prolongée. La tuméfaction, bien que certaines exceptions à cette règle se produit, est absolutelywithout la douleur, rougeur, ou autres en

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The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . od of ataxia, the patient * Buzzard, Pathological Transactions, vol. xxxi. p. 2G8. Qaz. des Hopitaux. Loc. cit. 428 DISEASES OF THE JOINTS, awakes with a limb greatly swollen, the enlargement being most marked ona level with the joint, where also it is most clearly aidematous or fluctuathig ;the ncighbtn-iiig parts are more brawny, and only pit on prolonged pressurewith the tinger. The tumefaction, although some exceptions to this rule occur, is absolutelywithout pain, redness, or other inflammatory symptom ; neither is there anypyrexia.* This condition is only transient; when it disappears it may leavethe joint normal or neiirly so (benign form). Or, on the contrary, when theswelling permits examination of the joint, very considerable changes may havealready supervened ; and these may go on rapidly to produce the most sin-gular distortions, dislocations, or both, becoming manifest a few days after theS^rst onset, as in the knees represented in Fig. 675, taken from Westphal. Fig. 675.. Tabetic Arthropathy. (After Westphal.) Besides dislocation, spontaneous fractures occur from the slightest force, suchas turning in bed, or simply while walking along the ward. A singular cha-racteristic is the almost complete immunity from pain, both at the dislocatedjoints and in the fractured bones. A patient described by Charcot, after anarthropathy had caused hip dislocation, used to walk some distance to heremployment as a bed-maker. After a time the other hip Avas luxated; herlegs were very movable but ill-controlled, and the joints flexible. So utterlypainless were her limbs, that she used to amuse herself and the neighboringpatients by floundering them about in bed. Durinir one of these performances, the left femur was broken; some time after, while changing her position inbed, both bones of the left forearm were fractured ; fifteen months afterwardsthe same accident occur

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