ellular infiltration and
exudation, resulting in the formation of new connective tissue which
encroaches on the cavity of the joint and gives rise to adhesions, and
by contracting causes stiffness and deformity. The articular cartilages
may subsequently be transformed into connective tissue, with consequent
fibrous ankylosis and obliteration of the joint. The bones are affected
only in so far as they undergo fatty atrophy from disuse of the limb, or
alteration in their configuration as a result of partial dislocation.
Osseous ankylosis may occur, especially in the small joints of the hand
and foot.

The disease is generally poly-articular and may be met with in childhood
and youth as well as in adult life. In some cases pain is so severe that
the patient resists the least attempt at movement. In others, the
joints, although stiff, can be moved but exhibit pronounced crackings.
When there is much connective tissue formed in relation to the synovial
membrane, the joint is swollen, and as the muscles waste above and
below, the swelling is spindle-shaped. Subacute exacerbations occur from
time to time, with fever and aggravation of the local symptoms and
implication of other joints. After repeated recurrences, there is
ankylosis with deformity, the patient becoming a helpless cripple. On
account of the tendency to visceral complications, the tenure of life is
uncertain.

From the nature of the disease, _treatment_ is for the most part
palliative. Salicylates are only of service during the exacerbations
attended with pyrexia. The application of soda fomentations, turpentine
cloths, or electric or hot-air baths may be useful. Improvement may
result from the general and local therapeutics available at such places
as Bath, Buxton, Harrogate, Strathpeffer, Wiesbaden, or Aix. In selected
cases, a certain measure of success has followed operative interference,
which consists in a modified excision. The deformities resulting from
chronic rheumatism are but little amenable to surgical treatment, and
forcible attempts to remedy stiffness or deformity are to be avoided.

#Arthritis Deformans# (_Osteo-arthritis, Rheumatoid Arthritis, Rheumatic
Gout, Malum Senile, Traumatic or Mechanical Arthritis_).--Under the term
arthritis deformans, which was first employed by Virchow, it is
convenient to include a number of joint affections which have many
anatomical and clinical features in common.

The disease is widely distributed in the ani