148 REMARKS ON THE TREATMENT OF OPEN JOINTS. 
this manifest ill success in the treatment of open joint which I 
witnessed at the Veterinary College, and my ideas on that sub¬ 
ject I now offer to your readers. 
In the first place, and in order that we may proceed in a 
systematic way, we will inquire what are the consequences of a 
wound into the cavity of a joint, what injurious effects are likely 
to arise therefrom, and what appears to be the most rational 
mode of everting those effects. Let us, for the sake of illustra¬ 
tion, suppose that the capsular ligament of a joint, the knee for 
instance, has been penetrated, and that a communication is thus 
established between the cavity and the external atmosphere: the 
wound of itself is of trifling importance, and in a merely mus¬ 
cular part, would scarcely require notice; but here this incon¬ 
siderable affair is likely to give rise to a train of results of a 
perplexing and annoying nature. First, the synovia, which in a 
healthy condition of the parts is confined within a circumscribed 
cavity, for the express purpose of affording a smooth and glib 
surface for the play of the bones composing the joint, finds an 
exit through the aperture, and becomes wasted. In consequence 
of this wasting of synovia, the joint does not retain a sufficient 
quantity for the due and healthy performance of its functions; 
the delicate membrane, therefore, which covers the cartilaginous 
ends of the bones, suffers a certain degree of attrition, the con¬ 
tinuation of which soon induces a state of inflammation. For a 
time, and before this inflammation increases to any great extent, an 
extra quantity of healthy synovia is secreted ; but no long period 
will elapse before we have the common consequence of inflamma¬ 
tion of a secretory organ, viz. a morbid secretion: thus, instead 
of synovia, a muco-purulent discharge makes its appearance: the 
inflammation pursues its course, the cartilages become ulcerated, 
and by-and-by coagulable lymph and bony accretions are thrown 
out, and anchylosis is the inevitable result. I have here hastily 
sketched the progress of a simple puncture into the cavity of a 
joint, when neglected or improperly attended to; but I have 
taken no note of the irritative or sympathetic fever which attends 
it, because it does not bear any direct reference to my present 
purpose : it is sufficient to notice, that in violent cases it is not 
an unfrequent occurrence for the poor animal to die from pure 
irritation produced by the pain attending inflammation of the 
ligamentous structure of a joint. 
From the statement I have given, it appears evident, and I 
think it may be laid down as a principle in veterinary surgery, 
that our first endeavour (after the removal of any extraneous 
matter which may have insinuated itself into the joint) should 
be to close the cavity; to put a stop to the flow of synovia, and 
