long life, but not with any active occupation, hence
those of the hospital class who suffer from it tend to accumulate in
workhouse infirmaries.

_Hydrops_ is most marked in the knee, and may affect also the adjacent
bursae. As the joint becomes distended with fluid, the ligaments are
stretched, the limb becomes weak and unstable, and the patient complains
of a feeling of weight, of insecurity, and of tiredness. Pain is
occasional and evanescent, and is usually the result of some extra
exertion, or exposure to cold and wet. This form of the disease is
extremely chronic, and may last for an indefinite number of years. It is
to be diagnosed from the other forms of hydrops already considered--the
purely traumatic, the pyogenic, gonorrhoeal, tuberculous, and
syphilitic--and from that associated with Charcot's disease.

_Hypertrophied fringes and pedunculated or loose bodies_ often co-exist
with hydrops, and give rise to characteristic clinical features,
particularly in the knee. The fringes, especially when they assume the
type of the arborescent lipoma, project into the cavity of the joint,
filling up its recesses and distending its capsule so that the joint is
swollen and slightly flexed. Pain is not a prominent feature, and the
patient may walk fairly well. On grasping the joint while it is being
actively flexed and extended, the fringes may be felt moving under the
fingers. Symptoms from impaction of a loose body are exceptional.

[Illustration: FIG. 160.--Arthritis Deformans of Hands, showing
symmetry of lesions, ulnar deviation of fingers, and nodular thickening
at inter-phalangeal joints.]

_The dry form of arthritis deformans_, although specially common in the
knee, is met with in other joints, either as a mon-articular or
poly-articular disease; and it is also met with in the joints of the
spine and of the fingers as well as in the temporo-mandibular joint. In
the joints of the fingers the disease is remarkably symmetrical, and
tends to assume a nodular type (Heberden's nodes) (Fig. 160); in younger
subjects it assumes a more painful and progressive fusiform type
(Fig. 161). In the larger joints the subjective symptoms usually precede
any palpable evidence of disease, the patient complaining of stiffness,
crackings, and aching, aggravated by changes in the weather. The
roughness due to fibrillation of the articular cartilages causes coarse
friction on moving the joint, or, in the knee, on moving the patella on