50 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



The primary lesion may only affect the periarticular region, not 

 directly extending to the synovial membranes, and only after an interval 

 of some days may symptoms of suppurating synovitis or suppurating 

 arthritis appear, in consequence of progressive invasion of the parts by 

 specially virulent microbes. 



TRAUMATIC TENDINOUS SYNOVITIS. 



Suppurative inflammation of the synovial burste of tendons in conse- 

 quence of wounds most commonly aft'ects the sesamoid sheaths of the 

 front or hind limbs ; more rarely, the tendon sheaths of the hock or 

 knee ; and, exceptionally, the small synovial sheaths of the extensors of 

 the metacarpus and phalanges, etc. 



Such inflammation follows injuries with forks, harrow teeth, or any 

 sharp foreign body. It is characterised by the existence of a fistula or 

 wound, indicating the course taken l)y the body inflicting the injury, 

 from which at first normal synovia escapes. Later, however, the 

 discharge becomes turbid, and after the second day gives place to a 

 clotted, serous, or pi;rulent fluid. 



A diffuse, oedematous, warm, painful swelling very rapidly develops 

 around the injury. The animal is more or less feverish and lame. The 

 swelling soon extends throughout the entire length of the infected 

 synovial sheath. The patient loses appetite, and unless treatment is 

 promptly undertaken, complications supervene which often necessitate 

 slaughter. The prognosis is always grave. 



Treatment. Continuous irrigation has long been recommended. It 

 is worthy of trial, but in the majority of cases occurring in current 

 practice it cannot be carried out. 



]\Ioussu prefers a form of treatment which he claims has always 

 succeeded in horses and oxen— viz., irrigation of the parts, followed by 

 injection of sublimate glycerine solution. 



He first washes out the infected synovial cavity with boiled water 

 cooled to 100 Fahr. A counter-opening may become necessary, and 

 the washing should be continued until the escaping water appears 

 perfectly clea,r. Immediately after each such irrigation he injects from 

 7 to 14 drams of glycerine containing 1 part in 1,000 of corrosive 

 sublimate. He lepeats this treatment daily. 



I!y reason of its affinity for water and for the liquids in the tissues or 

 suppurating cavities into which it is injected, the glycerine penetrates 

 m all directions, reaching the finest ramifications of the synovial sacs, a 

 fact which explains its superiority over aqueous antiseptic solutions. 



Suppuration is rapidly checked and repair becomes regular. The 

 pain and lameness progressively diminish, and recovery may be complete. 



