IN THE JOINTS. 
639 
2. A thick pledget of tow, thoroughly wetted with Veau de 
Rabel, was applied on the wound, and this was covered with 
other dry pledgets confined by tape or riband, and over this the 
laths were placed. 
3. If the dressings could not be fixed by these means on account 
of the conformation or injury of the part, the laths were loosened, 
and the pledgets alone were used. 
4. Twenty-four hours after the first dressing the joint was exa¬ 
mined. This was done with the greatest possible gentleness and 
care. A coagulum of synovia would generally be found on the 
orifice of the fistula—it was the condensation of the synovial al¬ 
bumen by the alcohol and the acid. Every care was taken that 
this should not be in the slightest degree disturbed. If the pledgets 
were too large, as would sometimes happen, and had imbibed too 
much of the liquid, they are not to be disturbed by stripping off the 
dressing, but the thickest and most prominent parts are to be cut 
off, and pressure made by a soft compress, in order to absorb as 
much as possible the liquid by which it is impregnated. 
5. The edges of the wound being well cleaned, and the coagulum 
somewhat lessened in size, fresh pledgets are placed over it mois¬ 
tened by the same liquid, and confined by flat pieces of wood as 
before. These dressings should be removed from time to time, 
according to the state of the fistula. It may happen that it will 
be necessary to renew the dressings twice in the day, and, on the 
other hand, they may occasionally remain three or four days without 
being disturbed. The quantity of pus which impregnates the 
dressing, and the intensity of the pain, are the circumstances by 
which we are to be guided. 
6. We ought not to cease to employ the spirit and acid at the 
removal of the different dressings while there remains a condensed 
clot in any part of the wound. 
When the clot drops off, no traces of the fistula will generally 
be found. It will then be necessary to dress the wound with 
I’eau-de-vie, or tincture of aloes. In a few days it will lose the 
black colour which the contact of Veau de Rahel gave it, and be¬ 
come of a lighter or darker vermilion hue. The pus which is 
secreted will be of a good character, and a cure will not be far 
distant. 
By this treatment, the cure of these fistulae is, as a general 
rule, very prompt, I have known them completely obliterated by 
one application of the fluid. 
7. When the inflammation is very intense, and the joint is much 
swelled, it will be necessary to have recourse to fomentations and 
emollient cataplasms, in order to ease the pain, and to restore the 
secretion of the synovia to its natural state. 
