INFLAMMATION OF THE JOINTS 339 



dressing). According to tho olx-^orvations of the writer, acute synovitis 

 occurs most frequently in the carpal joint, joints of the toes, in the knees, 

 and hip-joints. Paint the affected joint with iodine and keep the leg at 

 rest as much as possible. After the acute symptoms have subsided, mas- 

 sage the joint and allow light exercise. 



There are several irritations of the joints that are observed in the 

 work dogs of Europe that are not of interest to the English speaking 

 reader. 



The course of synovial inflammation of the joints is, as a rule, rapid. 

 If the patient receives proper treatment, in a short time we see an im- 

 provement (especially if the animal gets complete rest) . In other cases 

 the disease takes a chronic form — that is, it may form one of the follow- 

 ing conditions: (1) Chronic Serous Inflammation of the Joints (Synovitis 

 Chronica Serosa). In this the joint is slightly swollen and painful, 

 also very feverish. In some cases we may see a fluctuating sw^elling as 

 a result of enlargement of the capsule by serous secretion. If the disease 

 is still more acute, we may have a thickening of the fibrous capsules, and 

 very frec^uentl}' qviite an enlargement starting from the edge of the joint. 

 Chronic synovitis may appear in the onset of the disease, but, as a rule, 

 it results as a consequence of the acute form. The writer has seen 

 these cases in the carpus and knee-joint. The lameness is not especially 

 marked, l^ut any active movements increase it very much. (2) Purulent 

 Inflammation of the Joints: Suppuration of the Joints (Py arthrosis). 

 While the two forms which have before been descriljed are rarely accom- 

 panied by fever, it is quite different in suppuration of the joint. In this 

 there is great fever from the onset, which is ushered in by a chill. We 

 may see a more or less rapid swelling of the joint, which is extremely 

 painful. The joint is kept in a bent or flexed position, and the patient 

 walks on three feet. We may also see an oedematous swelling extending 

 both above and below in the neighborhood of the joint. The temperature 

 is considerably increased in some cases; the skin appears either normal or 

 reddened, sometimes even bluish red. The pus may eventually break 

 through the skin in the neighborhood of the joint or it may lie in the 

 joints, become absorbed, and cause pya'mia. 



This termination will occur even when the pus has broken out ex- 

 ternally, and in some cases where the inflammation has been very acute 

 we may have a subsequent adhesion of the joint (ankylosis). 



Suppuration of the joints is frequently produced by infected wounds 

 at or near the joint. In rare instances it may be the result of a phleg- 

 monous inflammation in the neighborhood of the joint; concussion or 

 crushing may also cause it, or it may occur in a metastatic way. Such 

 inflammations of the joints may also occur as a purely suppurative in- 

 flammation; but, as a rule, the inflammations are sero-fibrinous or sero- 



