GeneralBiseases of Bones, Joints and Muscles. 313 



ertions, as on the race-course, tlie back tendons being the 

 most common seat of the injury. Whether torn across or 

 divided with a cutting instrument, they are readily repaired 

 by the exudation of lymph between the divided ends and 

 its organization into white fibrous tissue. It is neces- 

 sary to support the limb so that the divided ends may be 

 placed in apposition and retained thus for three or four 

 weeks. Inflammation is to be checked by ordinary means. 



SPKAINS. 



When subjected to over-exertion, sinews become the 

 seat of sudden severe pain, inflammation, exiidation, thick- 

 ening and shortening. Sprains occur mainly from severe 

 and continued over-exertion, or from the sudden jerk con- 

 sequent on taking a wrong step when fatigued and unable 

 readily to recover the balance. They are most frequent 

 where tendons play over a bony process, but may occur 

 at any part, and are of all grades from those producing a 

 sUght halt, with almost imperceptible thickeniug of the 

 tendinous cord, to those in which the cord has been ex- 

 tensively torn and becomes the centre of a most violent 

 inflammation. 



Treatment. When violently inflamed or the seat of ex- 

 treme pain, the tendon should be rested and relaxed by 

 giving a suitable position to the limb, and fomented with 

 warm water or showered continuously with cold, untU heat 

 and tenderness have been subdued. Or cooling astringent 

 lotions may be used as advised under ostitis. A laxative 

 and restricted diet are often essential. When heat and 

 tenderness have subsided, occasional showering with cold 

 water and hand-rubbing, or stimulating liniments (cam- 

 phorated spirit ; liqiior ammonia 1 part, olive-oil 2 parts : 

 camphorated spirit and peppermint water equal parts, 

 etc.,) may be used. The same agents may be applied to 

 very slight cases at the outset. Or blisters may be ap- 

 plied as advised under ostitis. 



