AN ORGANIZED KNEE, ENSUING AFTER A
LONG COURSE OF THE ORDINARY TREATMENT.
THE APPEARANCE OF THE KNEE SUBSEQUENT
TO THE HEALING OF THE WORST CASE THE
AUTHOR EVER HAD UNDER HIS CARE.
When adopting the foregoing mode of treatment, no bandages are to be employed. Such wrappers only augment the heat inherent in every species of inflammation. They dam up the pus and speedily become foul and offensive rags; cleanliness is one of the primary requisites toward good surgery.
No caustics of any kind are imperative or even necessary. The two lotions, if used with proper zeal, will accomplish all that can be desired. The arnica lotion should, however, be in all cases applied night and day during the early stage; the chloride of zinc lotion ought to be employed only during the time man is usually out of bed.
The wound, in ordinary cases, should not be washed or touched. Should proud flesh start up, such is positive proof of the negligence of the groom, whose duty it was to apply the chloride of zinc lotion. If the mode of treatment here laid down be strictly pursued, the author can with confidence promise a satisfactory and a speedy cure. To enforce the value of the measures recommended, the portraits of two knees, which were subjected to the opposite processes, have been presented. Both were copied from living subjects in the sixth week after the misfortune had occurred.
OPEN SYNOVIAL CAVITIES.
The primary cause of these fearful accidents is the pride of mankind; gentility is always striving to impose upon credulity. It loves to be mistaken for something better than it really is. After all, this vice of society is nothing more than the child's game of "Lords and Ladies," played by grown-up persons. A horse having a naturally defective neck is obtained; no barbarity is too abhorrent to repress the hope of making people believe the steed thus deformed is a creature of extremest value. The animal, if ridden, has the chin pulled in close to the neck; if driven, the free carriage of the body is prevented by the cruel bearing-rein. The horse progresses in agony, while gentility sits smiling at the result of its artifice. The horse cannot see the ground before it, because of the constraint imposed upon the head; it cannot fix attention upon its duty, because of the agony which the cunning of gentility inflicts upon the lips. The pace is always rapid; the action is high as in the case of blindness; and the animal generally comes to the earth with violence. The skin upon the knees is divided, and the structures beneath are penetrated. One or more synovial sheaths are opened, while the cavities formed by the junction of the separate bones may be lacerated.
Sheath or joint may not be immediately opened by the fall, but either may have their integrity destroyed through the slough induced by the contusion consequent upon a broken knee. Moreover, various accidents will occasionally happen—misfortune is of infinite variety. The synovial bursæ, sheaths, or cavities of the hind legs are occasionally punctured by the quadruped kicking violently while in harness. The capsule, embracing the tendon of the flexor brachii upon the point of the shoulder, has been opened by the animal drawing a vehicle being run into; or by the horse running away and coming in contact with some obstacle. Any synovial cavity within the body may be penetrated by an unfortunate combination of circumstances; or by the unbridled passion of the groom, who may have a pitchfork near at hand. So also they have been cut into by the arrogance of unskillful operators. However, it matters not how the misfortune may arise, the mode of treatment and the manner of cure is in all such cases exactly the same.