One case mentioned in the text illustrates this. Gi A 'tli tli.I'cal and constitutional symptoms maybe;ht. Sooner or later, however, the anset up, sometimes with great -verity. difficult to understand tin- peculiar progress of trim-shot wounds of the knee, when we consider how sensitive to injury are shut cavities when inclosed by such a delicate membrane as the vial lining of the knee, and how feelingly such! th" introduction of air within them; how rapidly they degenerate under th" effects of this air; what a mass of closely-compacted tissues become is set up in such an articulation; it is that bone, lipuncnt, and soft parts participate in the injur. wide the bony expanse is which I formation of the joint; and what a! is presented tor purulent absorption and transmitting inflammation, as well as how difficult it is for H '>r morbid secretions to obtain free exit. by the injuries under conso often followed by dangerous and fatal life, wounds opening the joint are commonly eaitsed by instruments.
Foreign 1are seldom i; '. and the bones cnterin.:into the artie.-dl injured. The wound carefully. often adheres, and, by appropriate nvat'. littl"; tbllow. But if a ball be the wounding a' bodies are almost sin introdm 1 within by the b HI supp fore it closes, 1 withoui th OF Tin: f accumulating in the cavity; air thus gets admission, and works destruction. Foreign bodies cannot be extracted by so small an opening from a cavity of such a construction; and thus these gun-shot wounds of the joint, though often apparently very trivial injuries, become the most serious almost of any which can l>e i resented to us. The primary dangers of these wounds are not great.
It is in those which are set up afterwards that the chief hazard exists. The long and wasting suppuration, the tedious and dangerous abscesses, and the purulent poisoning are the principal sources of alarm. These abscesses are most curious occurrences in knee cases. They appear almost invariably among the muscles of the thigh; and while they may remain long unnoticed, they give rise to the utmost trouble and danger. They burrow along the bone, often stripping it of its covering, and yet are seldom apparently in connection with the joint. The escape of some small amount of the acrid secretions into the superficial or deep cellular membrane, sets up renewed inflammation and suppuration there, and thus abscesses form, whose connection with the original depot it is difficult to trace.