The Synovial Membrane and the Synovial Fluid with Special Reference to Arthritis and Injuries of the Joints

This monograph is based upon the findings of a large amount of original research conducted by the author over a period of fifteen years. His work proves that the old theories regarding the structure and function of the synovial membrane, and the origin and function of the synovial fluid, are inadequate. A proper study of the synovial membrane reveals that it is not a simple structure throughout; it contains secretory elements in certain areas. These areas produce the normal synovial fluid, which consists chiefly of mucin, by active secretion. This would seem to dispose of the theories which seek to account for the presence of mucin by calling it the interstitial tissue of the synovial cells, produced by their degeneration. In pathological conditions, effusions consist of the mucin produced by the activity of the secreting cells and also of a transudate or exudate derived, via the synovial membrane, from the circulation. There is thus ascribed to the synovial membrane a_ dual structure and function, and to the fluid a dual origin. Much of the book is taken up by descriptions of experimental technique and results, and tables of data and other findings. The concluding chapters indicate the clinical applications of all this work, and the reader will find suggestions for routine biochemical and microscopical investigation of .joint effusions. A thoughtful and painstaking book, it is .recommended to those interested in the problems of joint conditions, both medical and surgical.