GENERAL DISEASES OF THE JOINTS. IW 



If suppuration ensues there is the greatest danger of destruc- 

 tion of the joint. 



INFLAMMATION OF THE SYNOVIAL CAVITIES — BURSiE AND 

 SHEATHS OF TENDONS. 



Bursce are little synovial cavities placed between the skin 

 and prominent bony processes to favour the gliding of the one 

 on the other. TheccB are similar sacs interposed between bones 

 and fibrous cords (tendons, ligaments), or between two such 

 cords, to favour gliding. Each may be the seat of inflammation 

 with its consequences — over-distention from excessive secretion 

 of serum — exudation of lymph, with thickening, induration, 

 adhesion, calcification of the walls, or with suppuration. 



It may be developed by wounds, punctures, cuts, bruises, 

 sprains, or rheumatism, and is manifested by heat, pain, tender- 

 ness, and an elastic swelling (wind-puff, wind-gall), the enlarge- 

 ment usually remaining after inflammation has subsided. This 

 condition, as well as induration or calcification of the walls, 

 causes material deformity. Suppuration is evinced by a great 

 increase of the heat and tenderness, with a more distinct and 

 superficial fluctuation and a surrounding engorgement which 

 pits on pressure. 



Treatment consists in rest, a relaxed posture of any tendons 

 implicated, and soothing, cooling, or astringent applications, as 

 in the early stages of sprains or ostitis. A purgative, and 

 restricted diet are equally necessary. When heat and tender- 

 ness have subsided a small blister (see periostitis) will often 

 cause absorption of the liquid; or it may disappear under 

 pressure maintained for two hours at a time, twice daily at firsts 

 and increased by two hours daily ; or finally, the liquid may be 

 drawTi off by the nozzle of a hypodermic syringe, and the sac 

 compressed with a bandage (and, if necessary, pads) saturated 

 in an astringent cooling lotion. After evacuating the liquid an 

 injection of compound tincture of iodine i part, water 2 parts, 



