INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 103 



mation and thickening of the synovial memhranes, intra-articular 

 exudation, and sometimes grooving of the cartilages without ulceration 

 of the articular surfaces a^nd without disorganisation of the joint. 



The plastic form, on the other hand, leads to destruction of the 

 cartilages, ligaments, and sub-cartilaginous bony layers, induration and 

 calcification of the walls of the synovial cavity, and even periostitis of the 

 ends of the bones, with the formation of false joints. The internal 

 surface of the inflamed synovial membranes begins to granulate, the 

 fibrous clots distending the articular dilatations are perforated by 

 these extending granulations, and fibrous tracts soon develop even 

 in the articulation itself, undergo calcification, and produce complete 

 anchylosis. 



Diagnosis. The diagnosis is easy. The animal's history and 

 symptoms, and the stationary character of the pain in the earlier 

 stages are sufficient to prevent any error. 



Prognosis. " The prognosis is grave, but not fatal. In the exudative 

 form recovery may follow early treatment. In the plastic form, however, 

 the chances of success are extremely- meagre. 



Treatment. It is easier to prevent than cure, particularly in these 

 forms of arthritis. The means are simple, and consist in always 

 treating the post-partum infection as soon as it is recognised. The 

 animals can be effectively safeguarded against later articular complica- 

 tions by the free use of intra-uterine antiseptic injections, until the 

 uterine injuries have wholly healed, and by the administration of saline 

 purgatives and diuretics. 



When infectious arthritis is diagnosed, it is still necessary to resort 

 to the same methods if the uterine symptoms persist, and to complete 

 the treatment by local applications. 



The best method of local treatment seems to consist in puncturing 

 the articulation aseptically, removing almost all of the liquid exudate, 

 and immediately thereafter firing the skin covering the joint in points 

 or lines. 



If treatment has been invoked too late, if plastic arthritis with 

 the formation of fibrous bands within the joint and destruction of the 

 cartilages and calcification of ligaments, etc., already exists, there is no 

 economic object in undertaking treatment. Fattening may be attempted, 

 or the animals may be handed over to the butcher, if wasting is not too 

 far advanced. 



The use of cold douches, plaster bandages, blisters containing nitrate 

 of mercury, painting with sulphuric acid, etc., are too inconvenient and 

 too inefticient to be recommended in actual practice. Similarly, the 

 salicylate of soda, which is so useful in simple rheumatism, has no real 

 superiority over diuretics in this condition. 



