226 DISEASES OF THE JOINTS. 



Such, then, is the treatment when the lips of the wound admit of 

 being brought into apposition, and when the practitioner has been 

 called in before the advent of suppuration. If it be a lacerated 

 wound, its lips must be brought together as well as possible, and 

 retained in that position by the application of the styptic colloid. 



If these means are ineffective, if the injury has been inflicted for 

 a longer period than a few hours, when inflammation is already 

 established, and pus has commenced to be formed to plug 

 up the wound at this stage would only cause the fluid accura- 

 lated within the capsule of the joint to burst out at some other 

 spot, but even in this stage much can be done by irrigating the 

 joint and surrounding structures with a solution of corrosive 

 sublimate — 1 to 500 parts of water — in order to destroy all 

 germs which may have gained entrance, and then by covering 

 the external wound with several layers of iodoform and varnish 

 paste. If the discharges be profuse they must be allowed to 

 escape, but much can be done to prevent the admission of 

 atmospheric germs by the careful adjustment of boracic lint 

 and light antiseptic bandages, through which the discharges will 

 escape. If the discharges diminish and the bandages cause 

 no inconvenience or irritation, they should not be removed until 

 the cure has been completed. Every wound which has com- 

 menced to suppurate must heal by granulations ; and the more 

 perfect formation of these goes on in the deeper-seated parts of 

 the wound — that is to say, that the healing is from within 

 outwards. The plugging of the outer orifice while pus is being 

 formed causes it to accumulate in the joint and surrounding 

 structures, adds to the suffering of the animal, and in too many 

 cases causes its death. 



An extended experience warrants me in recommending the 

 application of a blister to the whole surface of the joint, as 

 the most successful treatment that can be adopted if the wound 

 has failed to heal by the primary or adhesive process. The blister 

 acts by removing pain, limiting motion, exciting the formation 

 of healthy granulations, and (as a result of the swelling it pro- 

 duces) causing the approximation of the surfaces of the wound. 



The coagulum of synovia which accumulates upon the wound 

 should never be removed, as it prevents the admission of air and 

 of germs into the joint, and thus limits the formation of pus. 



