40 
WOUNDS OF THE ARTICULATIONS. 
to animals, which the surgeon resorts to in articular wounds 
of man when complicated, namely, the amputation of a 
wounded joint, which would not be of service among our 
domesticated animals. 
For a long time authors have endeavoured to give an 
explanation of the cause of the seriousness of articular wounds. 
The theories on this subject have generally been in con- 
formity with the doctrines of the day in which they have 
been written. Pare attributed the danger of these wounds 
to lesion of the aponeurosis of the tendons. Brasdor, Bichat, 
and Larry, to the involuntary resistance of the tissues to 
inflammatory swelling. David cites the action of the pus on 
the synovial cartilages, but which is only secondary. Modern 
surgeons have especially regarded the introduction of the air 
as exercising a very powerful action on the articular surfaces. 
To combat this latter opinion, it has been said, that the 
introduction of air is not the cause of arthritis: as that it is 
not more irritating than an instrument, or the covering 
which is placed over the wound. 
The innocuousness of amputations to the contiguous parts 
has been particularly observed. In fact the disarticulation of 
a limb is far from producing so much acute suffering as that 
of an articular wound. We have frequently made amputa- 
tions of this kind on the dog, and have seen the wounds 
readily heal, without complication, and without requiring 
any particular care. In cases of this kind, the articular 
cartilages are absorbed and disappear by degrees, leaving in 
their place fleshy granulations, which precede cicatrization. 
To conclude : It cannot be denied but that air has a 
certain irritating effect on articular surfaces ; but it is not 
this action which is principally to be feared. One of the 
complications, the most to be apprehended, is arthritis; and 
this inflammation appears to result especially from the suscep- 
tibility of the various tissues which compose and surround 
the articulation. Until the present time, the effects pro- 
duced by the movement of the articulation have not been suffi- 
ciently taken into consideration. In order to avoid these 
complications, it is absolutely necessary that the affected 
part should be kept perfectly quiet, since practical observa- 
tion demonstrates that articular wounds are more or less 
successfully treated according to the mobility of their 
situation. 
(To be continued.) 
