WOUNDS OP THE ARTICULATIONS. 
37 
between the edges of the wound accompanied with the ex- 
udation of a serous liquid ; and occasionally one of these 
excrescences is more developed than the others, having in 
the middle of it an opening resembling a synovial fistula. 
In the progress of articular wounds which have been neg- 
lected, inflammation soon extends over the whole surface of 
the injured part : the contiguous tissues swell, and extreme 
pain is evinced ; much constitutional excitement is set up ; 
the pulse becomes increased ; the conjunctival membrane in- 
jected; the buccal membrane hot, and the thirst^intense. 
The animal either remains down, or at other times he con- 
tinues standing, because he instinctively is conscious of the 
extreme pain which is caused in moving, particularly when 
getting up after being down for a few minutes. The other 
extremities become tumefied, and insidious abscesses are 
occasionally produced on different parts of the body. 
Progress. — M. Velpeau has justly observed, that during 
the first few days after the infliction of these wounds, no 
symptoms of a dangerous character are manifested ; but this 
period of incubation having passed, that at the end of the 
third, fourth, or fifth day, reaction takes place with more or 
less force in the injured articulation, or in the organism 
generally. These effects are observed to be the same in all 
animals. 
Inflammation is. rapidly developed in complex articulations ; 
but in those which have no tendinous 1 ursae, it is less quick 
in its appearance than in the surrounding parts. 
Swelling of the joint shows the extension of inflammation 
over the articular surface. The absence of this swelling will 
lead the practitioner to anticipate the case to be of a difficult 
nature. 
Terminations. — The terminations of articular wounds 
are cicatrization, suppuration, gangrene, phlebitis and chronic 
arthritis. 
These wounds do not always terminate in death. If the 
patient immediately receives proper treatment, and if kept 
quiet, inflammation may not supervene in the articulation. 
Several examples of articular wounds cicatrizing in a few 
days can be cited. A favorable termination may be expected 
when there is a gradual diminution of pain ; a healthy ap- 
pearance of the wound, and the pus from its being of laudable 
character. So if the pain of the affected joint becomes easier, 
it indicates progression towards a cure. 
There is generally a swelling, which remains for some time - 
after the wound has healed, but this finally disappears. 
Suppuration of articular surfaces is a serious termination 
