CAPPED KNEE. 357 



fore mentioned. Good residts may always be insured from their 

 judicious and timely administration. Tn applying the powerful min- 

 eral inunctions much patience and wisdom are required. It should be 

 done by carefully and perseveringly rubbing in small quantities 

 daily: it should be done softly and gently, not with force of arms, 

 nor Avith the expectation of producing an astonisliing effect by heavy 

 dosing and nuiin strength in a few hours: it should be after the 

 manner of a siege rather than that of a charge. The object is to 

 induce the drugs to permeate the affected part until the entire mass is 

 penetrated. Of course cases will be encountered which resist all 

 forms of medical treatment. The tumor remains as a fixed fact; it 

 continues to grow : it is large and pendulous at the elbow : its weight 

 is estimated in i)ounds; it is not an eyesore merely, but an uncomfort- 

 able, burdensome mass, excoriating all the surrounding parts and 

 being itself excoriated in turn : mild treatment has failed and is no 

 longer to be relied on. 



Resort must now be made to surgical methods, and here again Ave 

 must choose between the ligature, the cauterv, and the knife. Each 

 has its advocates among practitioners. In a case like the present, one 

 of the difficulties arises in connection with the application and reten- 

 tion of bandages and other dressings after the amputation has been 

 jjerformed. It is a somewhat difficult problem, OAving to the con- 

 formation and proportions of the body of the patient, and iuA^olves 

 the exercise of a considerable amount of practical ingenuity to adjust 

 and retain the appliances necessary to insure a good final result. 



In the long description of the treatment of the varieties of capped 

 elboAv I have thus far omitted any mention of one method Avhich is 

 practiced and commended by not a feAv. I refer to the use of setons, 

 introduced through the tumor. ^ly oAvn experience and the observa- 

 tion of many failures from this method led me to abandon it. 



CAPPED KNEE. 



The passage of the tendons of the extensor muscle of the cannon, as 

 it glides in front of the kneejoint, is assisted by one of the little bursa3 

 before mentioned, and when this becomes the seat of a dropsical col- 

 lection a hygroma is formed and the knee is " capped." Though 

 someAvhat analogous in its history to the cai)ped elbow, there are 

 points of difference between them. Their development may proA^e a 

 source of great annoyance from the fact of the blemish Avhich they 

 constitute. 



Caifsc. — The capped knee joresents itself under various conditions. 

 It is sometimes the result of a bruise or contusion, often repeated, 

 inflicted upon himself by a horse addicted to the habit of paAving 

 Avhile in the stable and striking the front of the stall Avith his knees. 

 Another class of patients is formed of those Aveak-kneed animals 

 Avhich are subject to falling and bruising the front of the joint against 

 the ground, the results not being always of the same character. 



