General Diseases of Bones, Joints and Muscles. a()9 



suppuration. Glanders, farcy, plugging of the vessels, 

 etc., are distinguished by the presence of the coexisting 

 disease in other parts. 



General Treatment. In severe cases secure immobility 

 in the joints by placing in sliags, and, if necessary, by the 

 application of a smart blister around the articulation. In 

 the absence of the blister apply cooling or soothing lotions 

 as for inflammation of bone and follow this up by blisters 

 or firing when the inflammation has in the main subsided 

 and the heat and tenderness disappeared. In the slight, 

 subacute and chronic forms the counter-irritants may be 

 applied at the first. When anchylosis threatens it is 

 sometimes advisable to favor it by active blistering and 

 rigid immobility of the joint. If ulceration of the joint 

 surface occurs the hot iron usually gives the best results. 

 If suppuration has ensued the pus must, escape by an 

 external opening and our efforts must be thereafter di- 

 rected to limiting the inflammation as far as possible and 

 obviating death by the general fever, or uselessness, by 

 destruction of the joint. 



In the severer forms a purgative should be given at the 

 outset and this may be followed by a soft laxative diet 

 (mashes, roots, green food,) and diuretics, (carbonates or 

 acetates of potassa or soda, colchicum, etc.,) especially 

 when there is reason to suspect any rheumatic complica- 

 tion. In some cases of this, as of bone disease, in which 

 there is imperfect assimilation and the passage of an 

 excess of phosphates in the urine, a course of bitters and 

 iron tonics is demanded. 



Tuberculous disease of the joints demands similar treat- 

 ment with due attention to the general health to correct, 

 if possible, the unhealthy state. 



OPEN JOINT. 



This results from an incised, punctured, lacerated or 

 contused wound and will vary in gravity according to the 

 nature of the wound and the certainty of inflammation 

 ensuing. If there is a simple minute puncture or cut, the 



