Selected monographs.

Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

    351/368 page 317
    M to the touch. Considering the state of tilings, I think I was justified in forming the opinion that in consequence of the contusion blood had been at first cxtravasated, and subacute inflammation developed, which latter had been increased by the child's catching cold; and that the swelling now before me was an abscess, which contained pus mixed with blood, and which threatened to open out- wardly. As it was certain that the bone was involved, I thought it important to prevent the opening of the abscess as long as possible ; I therefore gave the advice to continue perseveringly with the appli- cation of cold, and to give some iodide of potassium .internally. Some months afterwards the little patient was brought to me entirely cured. The abscess had not opened, but had been absorbed under the continuous use of ice in three weeks' time. There remained not the slightest tenderness, and the arm coidd be moved in any direction with perfect ease ; even by the closest examination no trace of the previous disease could be detected. Inflammation of the bursa patella? is another form of acute, inflammation of frequent occurrence, which, according to most siugeons, cannot be dispersed in its advanced stages. Linhart, 'Dumreicher, and others, recommend the division of the inflamed bursa as soon as possible, for the purpose of giving free vent to the exudation, and thus of shortening the course of the complaint. Stromeyer, also, in his f Handbook' (p. 581), states that in these cases the inflammation cannot be dispersed even with the help of many leeches, and that poultices are to be applied, and an early opening to be made, especially where the bursa has burst, and has, by infiltrating the surrounding cellular tissue wit h pus, given rise to diffuse, suppurative inflara mation. Formerly I used myself to make an early opening, but now I almost always effect dispersion and resorption of the matter by continuous abstraction of heat, and hasten these effects by the application of some leeches. The case Which led me to adopt this mode of treatment was the following Case 14.—Inflammation of the bursa patella ; application of ice for thirteen days.—John K—, a working man, act. 30, accustomed to strong drinks, had worked in the cold weather kneeling on hard ground. From this he got a violent inflanunation of the bursa patellœ. When he came into the hospital the front of the knee was enormously swollen and fluctuating. The skin was red over half his le«, and
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