| OCR Text |
Show DISEASE or run KNEE JOINT. or COLLECTIONS IN THE Boasts. neutral salts, and after the bleeding and purging, an opiate at night will have the most soothing effect. When high inflammation attacks the knee in consequence applicaof a blow, and is subdued by evacuations and cold ary, tions, yet it will happen that the relief is only tempor are We . return will ce and the inflammation in all its violen deep the kept long in suspense by the great turnefaction, and pain, and are unable to say whether the cavity of the joint ce have at length partaken of the disease. When the violen paris of the inflammation cannot be subdued, and the relief tial, then suppurations form around the joint, which when very distinct, may be opened ; but I must here give this can- appeared trifling, and there was not the slightest pain or ltJli ,__.43§OW' mum the tion, that we may not be deceived, and take effusions into bursa, or into the cellular membrane, for abscesses. The inflammation will sometimes be continued and violent, and yet the joint escape from the capsule, checking the progress of the inflammation from the outward parts into the cavity. When the inflammation has been violent, there will be adhesions betwixt the tendons and their sheaths, and an oblit- eration of the bursa; The consequence is a stiff joint. Where the Constitution is uncommonly good, we may venture by friction and motion to restore the joint; but where I ,» p..- a a d . .‘g f'mfi"? "Name-dawn . the case has proved obstinate, and the inflammation has continued long, in a more obscure degree, we ought to try no such experiments as extending and moving the leg. Where the limb is longer than the other after any disease of the t, knee, it would be quite wrong to make the slightest. attemp are joint the for this circumstance shews us that the bones of enlarged. If the capulse of the joint should be wounded, pierced with a nail, or opened but in the smallest degree, there is seen a great danger to the joint, and even to life. I have face man sufl‘cring from such an accident, delirious, with his ul powerf in ng swelli flushed, the eye brilliant, the limbs , the :truggles, yet this high inflammation was long in coming the wound rumor of his adze had been struck into the joint. 102 discolouration for many days. I have not seen such inflamiglation of the knee fatal, but I can well believe that it may e. ‘ It is possible to mistake Dnorsr or rna Kym; JOINT for White Swelling, yet I should imagine it was easy to discover when there is fluid collected in the joint in any considerable quantity. In the relaxation and dropsy of the knee joint there is no pain; when we press the patella, the swelling is chiefly on the sides of the ligaments of the patella, it is soft and undulating, and putting the hand on one side of the patella, and tapping the other with the fingers, we are sensible of the fluctuation. It is a disease of weakness. The dropsv that occurs after fever is evidently so, and is removed with the returning strength. Often the swelling comes suddenlv, without its being possible to assign a cause, and it has been considered as a consequence of syphilis and scrophula. The first thing we have to think of, the most effectual, and that too which can do the least harm, is to apply a. good elastic flannel roller. I have seen swellings of the knee which were taken for the most confirmed disease disappear in a night. Stimulating frictions are to be employed when they do not interfere with the bandage, and moderate 6X01" cise is not only allowable, but necessary to the recovery of the joint, and to give vigour to the circulation. Froll] the violent inflammation which I have described, as a consequence of wounding the joint, it will be evident that my opinion must' be entirely against opening the knee jonit when such collections are formed in it. The Brass: which are around the joints are sometimes distended with fluid, while the joint is not affected. The bursa under the ligament of the patella, or the large bursa under the union of the quadriceps femoris to the patella, are sometimes full of fluid; these I would be averse from open- ing, because the opening will do no good unless there arise inflammation, and inflammation under the ligaments of the patella would quickly pervade the whole knee joint. |
