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As the term synovitis merely refers to the tissue involved, it should always be used with an adjective such as gouty, gonorrhœal, or tuberculous which indicates its pathological nature. The terms hydrops, hydrarthrosis, and chronic serous synovitis are synonymous, and are employed when a serous effusion into the joint is the prominent clinical feature.
If, for instance, there is a catarrhal affection of the serous and mucous membranes of the respiratory tract accompanied by fever, the allopath will give quinine in large doses to change this condition. He may accomplish his aim; but if so, he does it by paralyzing the heart, the respiratory centers, the red and white blood corpuscles and the excreting cells of the mucous membranes.
Streptococci invade the lymph spaces, and are associated with acute spreading conditions such as phlegmonous or erysipelatous inflammations and suppurations, lymphangitis and suppuration in lymph glands, and inflammation of serous and synovial membranes, also with a form of pneumonia which is prone to follow on severe operations in the mouth and throat.
I don't know whether it was my determined conduct at the allocation, my territorial title, or a most exaggerated idea of my circumstances, that worked upon the mind of Mr. Sawley. Possibly it was a combination of the three; but, sure enough few days had elapsed before I received a formal card of invitation to a tea and serous conversation.
The wound should be dressed with tincture of aloes, and a thick bandage placed round the neck, to prevent the dog from scratching the part, which often causes dreadful laceration. These tumours in the throat of the dog are not always of a phlegmonous character. They are cysts, sometimes rapidly formed, and of considerable size, and filled with a serous or gelatinous fluid.
The skin on the surface of the body rose in bubbles of various sizes, and in places hung in patches. The hair was dark and thick, and fell off at a slight touch. The eyes came out of their orbits, and the pupils were dull. A frothy, serous fluid flowed continuously from the cavity of the mouth, the nostrils and ears. The mouth was half open.
Lord of the cauldron, stood a man dispensing ladlefuls of the rich simmering mess to his fellows, as they brought their bowls for their morning allowance: and he varied his occupation by pouring the same into certain small baskets, the serous part running off through the wicker and the residue caking as it cooled. On the same board stood the cheeses, previously made from the cream.
The risks incident to this class of wounds are: the extreme difficulty, especially when a dense fascia has been perforated, of rendering them aseptic, on account of the uncertainty as to their depth, and of the way in which the surface wound closes on the withdrawal of the instrument; different forms of aneurysm may result from the puncture of a large vessel; perforation of a joint, or of a serous cavity, such as the abdomen, thorax, or skull, materially adds to the danger.
Burns over the serous cavities abdomen, thorax, or skull are, other things being equal, much more dangerous than burns of the limbs. The risk of œdema of the glottis in burns about the neck and mouth has already been referred to. Children are more liable to succumb to shock during the early period, but withstand prolonged suppuration better than adults.
In a small number there is an abundant serous exudate, and with this there may be a considerable formation of fibrin, covering the surface of the membrane and floating in the fluid as flakes or masses; under the influence of movement it may assume the shape of melon-seed bodies. More rarely the joint contains pus, and the surface of the synovial membrane resembles the wall of a cold abscess.
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