OPEN JOINT. 355 



718. Chief danger in open Joint. 



The chief danger in open joint arises from the excessive pain, which is 

 paused by exposure of the synovial membrane to the air. Hence arise 

 fever and constitutional disturbance. In some cases the whole of the 

 membrane may become inflamed, and then the synovial fluid will be 

 altered in character. The ends of the bones may also become inflamed, 

 and abrasion of the articular cartilages, which tip them, may take place. 

 Hence again will arise increased irritability and inflammation. Bones, 

 though nearly insensitive in health, are in common with all parts which 

 have no power of swelling, exceedingly sensitive under inflammation. 



Violent inflammation in the joint, if continued, will ultimately destroy 

 the articular cartilages, and the bones themselves will then come in con- 

 tact. In such cases the pain and constitutional disturbance is so great, 

 that either death soon puts an end to the sufferings of the animal, or 

 nature throws out a mass of bone, which causes anchylosis, or stiff joint. 

 The pain ceases when this latter process is completed, but the animal is 

 useless or nearly so. 



The supervening of inflammation in excess in the interior is not, how- 

 ever, a necessary consequence, even though the joint may remain open 

 for some days. In healthy subjects with judicious treatment joints have 

 been known to remain open upwards of a week without any such occur- 

 rence, and have ultimately healed up satisfactorily. 



A favorable opinion may indeed always be entertained of any case, 

 unless or until such inflammation sets in. But when this occurs, the 

 chances of a successful result are very doubtful. 



Again, the process of suppuration or formation of pus always super- 

 venes on any considerable amount of inflammation in the part. When 

 this process has once commenced, there is no use in trying to heal the 

 wound by closing the orifice and thereby excluding the air ; because pus 

 once formed must have an exit, and, if debarred from it in one place, 

 will make it in other. 



719. Treatment. 



The treatment divides itself into two heads, namely, that of the con- 

 stitutional disturbance, and that of the local injury. 



The first named will be best treated by perfect rest, deprivation of all 

 corn, laxative diet, abundance of fresh air, and by the administration, as 

 soon as the horse is properly prepared, of a mild dose of aloes. Physio 

 in full quantities is apt to produce superpurgation on account of the 

 general irritability of the system. 



The treatment of the local injury consists primarily in washing the 

 wound clean. There is no need or advantage in probing it or in attempt- 

 ing to remove every particle of gravel from the interior. Nature by her 

 own processes, and with less irritation to the patient than by the use of 

 any mechanical means, will speedily eject any foreign bodies which may 

 have lodged deeply in the wound. 



