CHAPTER IX. 
LYMPHATICS. 
I. 
CONTUSIONS—WOUNDS—FISTULAS. 
The slightest cutaneous or mucous wounds involve the lymphatic net- 
work, whose numerous canals drain the superficial layers of the dermis. 
Limited to the capillaries, these lesions are without importance: a small 
quantity of lymph mixes up with the blood, then the divided vessels 
cicatrize. They offer a certain gravity when large vessels are open. In 
animals, the superior face of the internal -face of the legs and round the 
articulations are places where these wounds are most met. They give 
flow to a serous liquid, which might be mistaken for synovia, when the 
traumatism is near an articulation. The weak viscosity of the lymph, its 
whitish color, its coagulability, abundance of its white globules, the cessa- 
tion or increase in the flow whether pressure is applied in the direction of 
or against the current, all those. establish the diagnosis. Often at the 
moment the wound is made, there may be seen a true jerk of fluid, which 
afterwards escapes in sheath, more or less abundant, increasing by exer- 
cise, which may make the flow return by jerks. 
A pinned suture is generally sufficient to arrest the hemorrhage. The 
compression of the leg, from its extremity to above the lesion, made with 
a flannel or a rubber roller, completed with an antiseptic dressing, slightly 
compressive, also gives good results; by this way, the exit of the lymph 
contained in the open vessel is stimulated and the fluid mass carried during 
the following days is reduced, thus facilitating cicatrization. Spontaneous 
recovery is possible even in large lymphatic canals. Monro has seen, in a 
pig, the thoracic duct, artificially wounded, cicatrize rapidly. 
Having become fistulous, lymphatic wounds are tenacious. They are 
treated by cauterization with nitrate of silver or sublimate or with the red 
iron. Some practitioners prefer the injection of tincture of iodine. 
Ligature applied on the peripheric end will be used if other means have 
failed. It is sometimes difficult to apply it, and the operation is 
frequently followed by an infiltration of some size of the extremity. Abso- 
lute rest is indispensable, if quick recovery is expected. Infectious inflam~ 
369 
