General Diseases of Bones, Joints and Muscles. 311 



the one on the other. Thecce are similar sacs interposed 

 between bones and fibrous cords (tendons, ligaments,) or 

 between two such cords, to favor gliding. Each may be 

 the seat of inflammation -nith its consequences — over- 

 distension from excessive secretion of serum : — exudation 

 of lymph, with thickening, induration, adhesion, calcifica- 

 tion of the walls, or with suppuration. 



It may be developed by wounds, punctures, cuts, bruises, 

 sprains or rheumatism, and is manifested by heat, pain, 

 tenderness and an elastic sweUing (wind-puff, wind-gaU,) 

 the enlargement usually remaining after inflammation has 

 subsided. This condition, as v/ell as induration or calci- 

 fication of the walls, causes material deformity. Sup- 

 puration is evinced by a great increase of the heat and 

 tenderness, with a more distinct and superficial fluctua- 

 tion and a surrounding engorgement which pits on press- 

 ure. 



Treatment consists in rest, a relaxed posture of any 

 tendons impUcated, and soothing, cooling or astringent 

 applications as in the early stages of sprains or ostitis. 

 A purgative, and restricted diet are equally necessary. 

 When heat and tenderness have subsided a smalX blister 

 (see periostitis) ^vill often cause absorption of the liquid ; 

 or it may disappear under pressure maintained for two 

 hours at a time, twice daily at first, and increased by two 

 hours daily ; or finally, the liquid may be drawn oS by the 

 nozzle of a hypodermic syringe and the sac compressed 

 with a bandage (and, if necessary, pads) saturated in an as- 

 tringent cooling lotion. After evacuating the liquid an 

 injection of compound tincture of iodine 1 part, water 2 

 parts, may be thrown in and expressed again after three 

 minutes, the part being afterward covered with wet band- 

 ages. 



For suppuration a simple subcutaneous bursa may be 

 laid freely open and allowed to heal by granulation, or a 

 thread may be drawn through the cavity and the pua 

 drawn off, while cooHng lotions are applied to the surface 



