576 TREATMENT OF INFLAMMATION OF THE FLEXOR TENDON'S, 
slightly involved. Moller saw a liorse in which the affection changed its 
seat several times in a few days: leaving the hind, it attacked the front 
limbs, and vice versa (rheumatic tenositis). 
Treatment. The most important point is to stop work; where 
possible, absolute rest should be given, and the shoe removed. Fresh 
cases, due to mechanical injury, are treated during the first twenty-four 
to forty-eight hours by cold applications, the best form being immersion 
or irrigation, but after this time little good results from the employment 
of cold. Moist warmth, supplemented by proper bandaging, is then 
preferable, and is applied as follows :—After carefully cleansing the foot, 
two longish rolls of tow rather thicker than a man’s thumb are moistened 
and laid lengthwise on either side of the diseased tendon, close to the 
metacarpus, and fixed there by a linen or cotton bandage, wetted and 
applied pretty tightly. Over this a dry woollen bandage is placed, so as 
to exercise regular pressure on the material below and on the diseased 
spot; when available, a piece of rubber tissue or waxed linen may be 
placed between the two bandages. Some practitioners envelop the 
limb thickly in cotton-wool, over which a calico bandage is tightly 
applied. This dressing is changed every four hours; the moist warmth 
and regular pressure favour reparative changes; excessive extravasation 
and cellular proliferation are checked, and resorption assisted. The 
rolls of tow or cotton-wool must exercise even pressure on the diseased 
tendon. 
When pain disappears massage may be resorted to during the interval 
of changing the dressing, the injured tendon being rubbed from below 
upwards with the thumb and fore finger, using moderate pressure, for 
about five minutes at a time, the parts being meanwhile covered with a 
piece of paper (see Dollar’s “Operative Technique,” p. 190). The 
operation must not be persevered with if pain or swelling follow. 
When early and carefully used, massage cures and removes the 
swelling in cases where, with the antiphlogistic methods formerly 
employed, thickening almost always remained. The slight vascularity 
of tendons in no way supports the theory of the action of cold ; on the 
other hand, moist warmth and methodical compression assist absorption, 
and are certainly not so likely to impede repair as cold. Experience shows 
this treatment to be by far the best. 
Infriction with ointments or fluids act like massage, though the 
specific resolvent effect ascribed to preparations of mercury and iodine 
causes them to be most widely used. A mixture of unguentum hydrargyri 
and sapo viridis in equal quantities can be used, with double the amount 
of lanoline where massage seems called for. Warm baths of soap or weak 
potash solution considerably assist absorption. 
The action of blisters is largely due to the mechanical effect of 
