CHAPTER XII. 
ARTICULATIONS. 
I. 
CONTUSIONS. 
The severity of contusions depends on the nature of the interested tissues, 
the intensity of action of the injuring agent, the thickness of the muscular 
layers which surround the joint. Always a more or less active local in- 
flammation takes place in the skin and the tissues underneath; it spreads 
‘sometimes deeply, as far as the ligaments, the synovial, the bones, when 
the contending agent has acted with great force. 
During the days that follow, the region swells, becomes painful, the 
‘motions of the joints are very painful, and the lameness is intense, if the 
-articulation belongs to one of the extremities. 
For slight bruises, cooling applications (douches, astringents, compresses) 
-or resolutives (camphorated alcohol) and rest are sufficient: the inflam- 
matory symptoms soon subside. When the contusions are more severe, 
‘specially if the swelling is great, cold is good first. Later, warm baths, 
compressions, massage constitute the means of choice. For the superior 
joints of extremities, blisters are often used to insure immobilization of 
the joint. In some cases, the inflammation remains acute and the synovial 
‘membrane secretes with abundance ; the treatment must be that of closed 
arthritis. 
II. 
SPRAINS. 
This is a kind of incomplete and temporary luxation. Under the action 
-of an excessive movement of flexion, extension, abduction or adduction, 
the articular surfaces are displaced and their means of union stretched ; 
but that only while the duration of the action of the cause lasts. 
The alterations produced are most variable as far as their severity 
goes; in mild cases, there has been only distension of the articular 
ligaments or rupture of some fibres; quite often they as well as the 
synovial are partly torn; it may happen that powerful funicular 
cords tear off with them the portion of bone upon which they are 
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