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When the nervous system is in a certain state, all impressions...
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The _temperature of the sick-room_ should not be much above 6...
Stage I Entering The Right Pyriform Sinus
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Burns Case Xxxv
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Knee Swelling Of Or Pain In
Source: Papers On Health
For ordinary slight injuries, complete
rest, and rubbing with spirit lotion, should be sufficient. But where
there is previous weakness, or constitutional tendency, even slight
pain and stiffness, caused by wet or some blow or wrench, the joint
must be treated thoroughly. Careless and wrong treatment may be given,
and result in severe lameness. We wish, however, to point out that the
treatment here recommended has cured many cases where this lameness
appeared hopeless, and even restored walking power in limbs which had
been ordered to be amputated by surgeons.
In the early stages of the trouble, it should be easy to cure in five
or six days. First apply the SOAPY BLANKET (see) at bedtime. Then,
about eleven o'clock in the fore-noon, place the leg so that the knee
is over a small tub or bath full of very hot water, as hot as can be
borne without pain. Pour this over the knee with a sponge or large soft
cloth for an hour, adding hot water as it cools. If the patient becomes
sick or faint, discontinue the bathing for a time. Dry the limb, rub
with olive oil, and dry again gently. At five in the afternoon repeat
the treatment of the knee. At bedtime sponge all over with hot vinegar,
rub with hot olive oil, and put to bed. If the joint has been
stiffened, gentle efforts to move it may be made during the treatment.
Sometimes during this treatment boils will break out over the knee and
discharge a good deal, but as soon as their work in removing disease is
done, these will heal up. Generally, however, this will not occur. The
diet may be such as we recommend in cases of ABSCESS (see).
In bad cases, the treatment may be continued for weeks before much
favourable change is noted. Patience and perseverance, however, will
win the day. The soapy blanket should not be given oftener than three
times a week, and a rest from all treatment on the Sabbath is best.
See also Housemaid's Knee.
Often in cases of knee pain and trouble, when local applications have
little power, a BRAN POULTICE (see) on the lower back will effect a
speedy cure. Sensible people will, of course, study and apply fresh
treatment in such cases. Where the knee, for instance, is in the hot
stage of inflammation, hot applications will be injurious. In such a
case, cold cloths on the knee, with bran poultice on the lower back,
will be the proper treatment. Try heat first, and if it is hurtful,
vary the treatment to cold and heat, continued as above.
Here, again, is a knee which gives its owner excruciating pain, and
shows only a little swelling and no sign of diseased matter whatever.
The hot fomentation and cold towels have both been tried, but there are
now and again symptoms that show us that the root of the evil has not
been reached. We try cold cloths on this knee, but they greatly
increase the pain. We at length suspect that it is not the knee that is
seriously diseased, but the root of one or more of the nerves that
supply the link from the lower part of the spine. By this time the pain
has returned into the knee dreadfully, and everything has failed. But
very soon after a large, thick towel, folded and wrung out of cold
water, having plenty of mustard spread on it, is placed across the
haunches, relief is given in the most charming fashion. The cold cloth
absorbs superfluous heat, and superfluous vital action to a certain
extent, but the mustard draws it out so much more speedily and
powerfully that the deep-seated roots of the nerves are reached and
cooled down to their normal action. The pain ceases, and the poor
sufferer blesses the mustard. We are just describing what actually
Sometimes a prejudice arises against heat. If, for example, an inflamed
knee has been strongly heated during the hot stage of the trouble, the
pains and injury will have been greatly increased. But one way or other
that hot stage of the trouble has been got over, and now without heat
it is impossible to cure. The patient, however, and probably the nurse
waiting upon him, are decided against all hot appliances. These do so
much mischief that it is believed to be out of the question to try them
again. It may be that the prejudice is so strong that you simply can do
nothing; it may not be quite so invincible as that. If you are able to
point out that it was only because the heat was applied at a wrong
time, or in far too great strength, and that now, since the
inflammatory power is spent, heat will be sure to have a good effect,
if it is only carefully applied, the prejudice may be removed. We have
seen a patient in this stage, and with both knees bad, wrapped in a
large hot blanket fomentation from the ankles to above the knees; and
he was constrained to exclaim, "That's the right thing, beyond all
doubt." Then there is no more prejudice.
Sufferers should not be disappointed if for a week or two they are not
sensibly better. In some cases the effect is apparent in four or five
days, but generally a fortnight or three weeks pass without much
encouragement. We see great despondency sometimes just before all pain
disappears. Still, as a rule, the new health is seen in the cheek and
eye very soon. Where a violent inflammation is obviously proceeding
in the knee, the TURNIP POULTICE (see) is the best remedy. If there
be great heat in all the body, there will be little or no need for
heating any part; judgment must be used for each individual case in
these matters. While resting as much as possible, the patient will find
it best to lie on the back, with the sore knee supported a little
higher than the body. A gently applied bandaging of the whole limb is
also very beneficial, and may be used for all weak limbs, even when the
patient is walking about.
In the treatment of stiffened knees, even where accidental bending of
the joint gives very great pain, it is a grave mistake to put the knee
in splints to prevent bending. What is wanted is to encourage bending
as far as that can be done without much pain, so that the joint may not
permanently stiffen. Even where, by the use of splints, permanent
stiffness seems to have been brought on, the warm-water treatment
recommended above will bring about a loosening and softening of the
joint, which will permit first of a slight bending, and then, with
gentle encouragement, a complete flexibility. The complete
restoration of the limb should be the object kept in view. No case of a
stiffened joint, although it may be free from pain and disease, can be
regarded as satisfactory, and hence treatment should be persevered in
until all stiffness is gone. Common sense will direct as to hot and
cold applications, when to apply each, and how long to continue either;
the patient's comfortable feeling being the very best guide. We are
glad to know of very many apparently hopeless limbs saved by our
treatment, even where it has been imperfectly carried out.
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