bifedive Lymphangitis. Traumatic Lymphangitis. 395 



A curious outbreak is described by Wiart as attacking nearly 

 every horse in the regiment that sustained a slight wound. A 

 tubercle looking mass formed in the depth of the wound was slow 

 to heal, and the lymphatics leading out from it became round, 

 corded, turgid, and at long intervals developed along their course 

 fluctuating centres which, whether opened spontaneously or by 

 the lancet, showed the same indolent habit. A single attack 

 would last from two to six months, and the actual cautery had to 

 be used on the sores. 



The lesions are those already described in the last article for 

 simple lymphangitis. For infecting cases they are those of the 

 particular disease which may be present. 



Diagnosis. The general diagnosis of lymphangitis is the dis- 

 tinction from phlebitis. In phlebitis the vein is blocked and can- 

 not be raised by pressure on the side leading toward the heart ; 

 in lymphangitis it can be so raised. The swelling and tenderness 

 are both greater in lymphangitis. The inflamed vein is more 

 rectilinear, the lymph vessel somewhat sinuous. If suppuration 

 ensues it is more diffuse in lymphangitis ; more restricted and 

 mixed with the elements of blood in phlebitis. 



For identification of the particular forms of infecting lymphan- 

 gitis, the reference must be made to the individual infectious 

 diseases. 



Treatment. In general the treatment of lymphangitis is the 

 antisepsis of wounds. Further than this the treatment of each 

 case is that of the particular disease which it represents. For all 

 cases alike it is important to apply vigorous treatment early, so as 

 to cut it .short bafore it can attain a dangerous extension. 



For the simpler forms of lymphangitis the wound should first 

 be thoroughly cleansed and disinfected. Washing with .soap suds, 

 or carbonate of soda will remove any greasy agent which would 

 prevent a thorough antisepsis. Then it may be washed with the 

 antiseptic lotion : — carbolic acid solution (1:20), or mercuric chlo- 

 ride solution (1:500), or zinc chloride (1:400) or potassium per- 

 manganate (1:160). If the infection has been introduced by a 

 small or punctured wound, the sting or bite of an insect, or the 

 prick of a sharp instrument it .should be freely cauterized to its 

 depth with lunar caustic incising it if need be to reach the whole 

 of the poison, and the surface afterward dressed with antiseptics. 



