676 OPERATIONS. 



for the longer they remain in the tissues, the more liable are they 

 to set up degenerative changes and adhesions, both of which are 

 very likely to produce permanent disability in the affected part, 

 as for instance, in the case of sprain. 



The removal of lymph is greatly facilitated by the fact that 

 numerous valves are present in the lymphatic vessels and in all 

 veins subject to local pressure from the muscles or tendons in their 

 vicinity. As these valves open only towards the heart, pressure 

 on tliese vessels will have the effect of driving the contained Ij'mph 

 or venous blood in the same direction, which is its natural course ; 

 its flow in the opposite direction being prevented by closure of the 

 valves. Under ordinary conditions, the flow of the lymph towards 

 the heart is chiefly effected by pressure due to the movements of 

 the muscles and organs of breathing. The good effects of this 

 pressure can be very beneficially supplemented, in health and 

 disease, by properly applied hand-rubbing (massage), which 

 important fact was recognised by the Chinese, 4,000 or 5,000 

 years ago ; by the natives of India, Fiji and Persia, for many 

 centuries; and by the ancient Greeks and Romans. Ambrose 

 Pare (1517-1590), the founder of scientific surgery in France, 

 appears to have been the first among Western surgeons to 

 recognise the benefits obtained from this practice. Since then. 

 Ling of Sweden (1776-1839) and other leaders of progress have 

 put massage on a scientific basis. In England, Sir William H. 

 Bennett (" Lectures on the Use of Massage "), Dr. Kendal Franks 

 ("The Dublin Journal of Medical Sciences," Nov. 1891), Dr. 

 Symons Eccles (" The Practice of Massage ") and many other 

 distinguished practitioners have wisely advocated its employment 

 in sprains, bruises, fractures, dislocations, diseases of joints and 

 nerves, and other affections in human beings; but veterinary 

 surgeons have been comparatively silent on this important subject. 

 It is true that they advocate hand-rubbing of the legs, which 

 practice, unfortunately for horses, is generally performed in a 

 wrong manner from above downwards, namely in a direction 

 opposite to that of the course of the lymph. 



Dr. Kendal Franks states that experience has shown that in 

 sprains, if tetken in hand at once, a cure may be effected in from 

 ten days to a fortnight ; slight sprains in a few days ; but even 

 in severe sprains, although some weakness may continue for some 

 weeks, the power to walk freely and painlessly is restored in a 

 short time, rarely exceeding a fortnight. If the treatment be 

 delayed until adhesions have formed, massage will be required 

 for a longer time; and if the adhesions have had time to become 

 firm, it may be necessary to rupture them under an anaesthetic 

 before massage can be expected to be of much avail. 



