CLOSED IDIOPATHIC ARTHRITIS, 345 
~we have in our care a magnificent animal cured from a pedal arthritis 
with baths and antiseptic dressings. Hydrotherapy, carried on for 
twelve days, had failed to produce any improvement. 
In the quite numerous cases where lameness remains, high neurotomy, 
that of the median or of the sciatic, must be resorted to. 
' / 
VI. 
CLOSED IDIOPATHIC ARTHRITIS. 
Between closed and traumatic arthritis there is the difference which 
exists between contusion and contused wound: no foreign body coming 
from the outside has entered the joint; that explains the rarity of sup- 
puration in closed articular inflammations. We do not speak here of 
the infectious arthritis; they will be considered farther on. Those that 
we will examine now result from local causes which, without ice 
the synovial, promote infammation in them. 
Wounds of joints which are not penetrating, violent contusions, 
Sprains, luxations, epiphysar fractures, are the usual causes. 
Closed arthritis is announced by heat, soreness and swelling. The 
synovial secretes freely; in its inside the fluid accumulates and 
dilates the weak points, but the peripheric cedematous swelling frequently 
conceals the dilatations. The characters of the intrasynovial effusion 
have permitted their division into serous, pseudo-membranous or purulent: 
To reduce the inflammatory manifestations is the first indication of 
treatment. General and local bleeding are useless. Even for the artic- 
ulation of the foot, the traditional local bleeding at the toe is abandoned’; 
it exposes to suppurative infection of the sub-horny structures. Em- 
ollient ointments, poultices, white lotion compresses, camphorated 
alcohol, are not as good as cold (baths, douches, continued irriga- 
tion) or immobilization with an appropriate bandage. “ Immobility 
is, par excellence, the antiphlogistic treatment of an inflamed joint”; it 
insures rest for the tissues and allows the rapid repair of articular le- 
sions. Speaking of sprain of the fetlock, we have shown the beneficial 
effects of the bandage of Delorme. By the immobility and compression 
it produces, this bandage constitutes a good treatment for more exposed. 
articular phlogosis. Its application is simple upon the phalangeal 
joints, that of the fetlock, knee and hock. With the superior articula- 
tion of the extremities (shoulder, elbow, hip, stifle) pitched plasters are to 
‘be recommended. There is often advantage to combine immobilization. 
with refrigeration. Many practitioners, from the start, use blistering. 
preparations, so as to modify the synovial inflammation; they are ad- 
4 
