Acute diffused periostitis or ostitis may be by these means prevented from running into acute necrosis, and the shaft of the bone may be saved and the patient's life rescued. The constitutional treatment will consist in absolute rest, a highly nutritious liquid diet, and large doses of Quinine with alcoholic stimulants. After the making of the incisions warm antiseptic poultices should be applied every few hours, and as the progress of the case indicates the formation of new collections of pus further incisions from time to time may be required. Where the death of the sink occurs in spite of free and early incisions, and it becomes separated from its epiphyses, the measures indicated under Osteomyelitis, to which category such cases belong, are to be carried out. Sequestrectomy will be indicated later on unless where an obviously dead shaft of bone is found lying loose in a bed of pus under the inflamed periosteum, in which case it may be removed at the primary operation.
Subacute periostitis following muscular exertion, and most commonly met with in athletes, especially footballers and cricketers, is best met by the application of a series of flying blisters.
Chronic periostitis is generally syphilitic. VI is to be treated upon the same general principles-- rest, counter-irritants, and Mercury with Iodides in very large doses, and incisions when these measures fail. It is not unusual to come across patients suffering from chronic and painful periostitis or nodes who have been taking mercury or iodides in a desultory way for months without benefit. Such cases generally yield rapidly to large doses of the iodide (2o to 3o or 4o grs.); full doses of Mercury just short of salivation may he also employed during the intervals in which the iodide is suspended.
Where syphilitic nodes fail to respond to the above measures, the thick ened periosteum should be freely incised and a piece of the dense compact bone removed by the gouge, trephine or Hey's saw.
The treatment of tuberculous periostitis is to be carried out upon the lines described under Caries.