UPON THE TREATMENT OP OPEN JOINT. 3 77 
ruptured, and recently so, from about two inches from the 
spine to the cordiform tendon. The stomach, which was 
nearly full of masticated clover, with part of the duodenum 
lying underneath it, was closely impacted within the cavity of 
the chest, and twisted about in such a manner that I was 
obliged to extend the opening into the thoracic cavity before we 
could return the contents into the abdomen. Hoping that I 
have not encroached upon your time and patience with this 
case of somewhat unfrequent occurrence, 
I remain, &c. 
The above bears a resemblance to Mr. Percivall’s case 
in the last number. 
UPON THE TREATMENT OF OPEN JOINT. 
By Edward Mayhew, M.R.C.V.S., London. 
It is now better than three years since I was seized with 
sickness, nor am I even yet perfectly recovered ; however, I 
am well enough to write this from notes which I had pre- 
viously taken, and I hope by autumn to be once more with 
“ harness on my back.” 
For a long time it occurred to me that the present treat- 
ment of open joints w r as based upon false principles. What 
could Coleman mean by the free use of the budding-iron, 
w r hich he both taught and practised? In the first place, 
when a knee is opened, the injury does not stop there ; we 
know r little of the real state the part w T ill ultimately assume 
for three days or a week ; we must wait till the slough has 
taken place before w^e can pronounce a definite judgment of 
the extent of the wound, then applying the hot iron, even 
supposing it upon each application to act as the late Professor 
intended, was merely to singe that which must eventually 
come aw r ay. It must, however, be a good-sized budding-iron 
which is to fit the orifice left after the vast majority of 
sloughs have fallen off. But put on one side the folly of 
that remedy, which is of no use when we most require assist- 
ance, did it never strike the advocates of the iron that if it is 
sometimes reparative, it is more often destructive in its 
agency ? Is it fair or prudent to employ upon other people’s 
property a remedy w'hich, if its chance of doing good do 
not answ r er, is certain of doing serious harm ? Yet I say too 
much when I allow it has a chance of doing good. Heat an 
iron to any extent that it may please the operator, then 
xxvi. 50 
