, SPRAIN OF THE FLEXOR TENDONS. 349 



nature. To enter into particulars, we shall first have to notice the 

 puffy swelling or knot, mentioned before, as being discoverable in 

 the course of the tendons, about the middle of the leg; the patho- 

 logy of which is, that effusion of fluid has taken place into the 

 sac or bursal cavity but lately described as existing within the 

 sheath of the flexor tendons : the effusion being, as it would 

 appear, different at one stage — or, rather, under one form of dis- 

 ease — from what it is under another. Suppose, for example, the 

 swelling, as it does in some severe forms of sprain, immediately 

 follows the accident ; we cannot, in this case, imagine it can con- 

 sist of any thing else but blood poured out from ruptured vessels ; 

 on the other hand, supposing, as in the ordinary case, some time 

 intervene between the sustaining of the injury and the appearance 

 of the tumour, we take it for granted that the effusion is of the 

 usual sero-synovial character, gravitating to the bottom of the 

 sac. Frequently, in slight sprains, it is not until the day follow- 

 ing that on which the accident happened that any swelling is 

 discoverable. I will relate a case to illustrate this. 



Sept. 4:ih, 1848. One of the horses composing the Queen's 

 Guard, after having walked perfectly soundly to the Horse Guards 

 on the day before, in turning out to return to Hyde Park Barracks, 

 was found to be so lame that, at the moment, it was thought he 

 was seized with the " cramp." Nevertheless, he was brought to 

 the Barracks, and there shewn to me. By that time he was so 

 far recovered that he walked sound, but still evinced lameness in 

 the trot. On examination, I discovered, a little below the back of 

 the knee, on the inner side of the leg, a puffy tumour extending 

 half way down ; not particularly tender to pressure, nor hot to the 

 feel ; and yet the sole apparent cause of the existing lameness. 

 It manifestly consisted of an accumulation of fluid within the 

 sheath of the flexor tendons ; the rationale of the case in my 

 mind being, that the horse had sprained his leg in going on guard 

 the day before. 



The above is what usually happens. But it is possible a sprain 

 may not evince any signs of its presence for two or three days 

 afterwards. A horse in the Regent Park Barracks was admitted 

 into the Infirmary for " lameness," the seat of which, in the ab- 



