Treatment---This is a disease that may be extremely severe, find may kill with great rapidity, and therefore, wherever possible, quali fied medical aid should be obtained.
For acute inflammation the limb must be kept absolutely at rest, the person being in bed. Warm cloths should be employed, and several leeches applied over the inflamed portion. Opening medicines, such as salts, seidlitz, should be given, and the person kept on low diet, no rich stimulating foods or large quantities.
If, however, the disease is chronic, especially when due to scrofula, that is to say, is tuber cular, the patient requires strengthening food and tonic medicines--good food, with change of air, sea-air being best, cod -liver oil, and tea spoonful doses of syrup iodide of iron repeated twice or thrice daily. The part affected may be blistered or painted over with iodine. The agonizing and continuous pain over a special spot due to an abscess in the bone can only be relieved by an operation by which the bone is cut into and the matter allowed to escape. This. of course, only a surgeon can do.
When caries or necrosis has resulted, the strengthening and tonic treatment is specially necessary. The discharge is nature's method of removing the diseased portions of bone, but it is a tedious method under which the sufferer may sink. It is, therefore, often advisable, and sometimes necessary, that the diseased portions should be removed by a surgical operation.
Inflammation of the Periosteum (Peri ostitis). — It has been noted how richly this outer fibrous coating of the bone is supplied with blood, and ali-o how growth of the bone in its thickness is dne to it. It can, therefore, be seen how seriously the bone may be affected by diseased of the periosteum.
The course of the disease is similar to that of inflammation of the bone proper. (I) Owing to tile great increase of blood, growth will be exces sive, and there will he considerable new forma tion of bone beneath the inflamed membrane. The thickening may, should the inflammation pass off, gradually diminish and become absorbed. The thickening may be so great as to amount to an actual bony tumour projecting outwards to a greater or less extent. In this case it is called an exostosis. The thickening of the bone will of course be of limited ex tent,and the result may be to produce distinct elevations or nodes of the bone, easily felt, and sometimes seen threugh the skin. (2) The disease may go on to suppu ration. This may be very serious, for the matter will collect underneath the periosteum, between it and the bone, separating the one from the other. Should the separation continue for any time, the matter not being allowed to escape, and the membrane not allowed again to become applied to the bone, then the surface portion of the bone from which the separation has been made, being deprived of its mmrisbment, will (lie and (3) necrosis results. Instead of necrosis,
however, there may be (4) ulceration of the surface of the bone—caries— determined by the bad constitution of the person. Periostitis occurring near a joint may extend into it.
The disease may be acute or chronic.
The causes of the acute form are cold and injury. Acute periostitis is often caused in school - girls by a wetting, the wet clothes knocking against the legs and so exciting the disease. The chronic form is due to con stitutional diseases like scrofula, syphilis, rheu matism, or gout. The scrofulous form attacks children specially, the parts oftenest affected being the sparely-covered bones, for example, those of the head, the collar-bone, and those of the leg (tibia) and arm (ulna). Syphilis is the most frequent cause of the chronic forms, and specially leads to the formation of limited thickenings and nodes.
Excessive use of mercury is also a powerful agent in the production of this kind of inflam mation.
Symptoms.—There is fever, quick pulse, loss of appetite, &c. The person complains of intense pain in the affected part, which is increased by pressing on time place and is aggravated at night. Care should be taken not to attribute this in children to growing pains, or in older people to rheumatism. After a little time the part becomes swollen, and time skin over it red and glazed, which again is liable to be confounded with erysipelas (Rose, St. Anthony's fire).
Treatment.—A. For acute attack. (1) Rest in bed, the affected limb being raised on pil lows. (2) Low diet—milk, &c. (3) Saline pur gative medicines—salts, seidlitz, &c. (4) Put several leeches over the affected part, and after they come off use warm fomentations. After the acute attack has passed off the patient may be very low and exhausted, when nourishing food and tonic medicines (such as tincture of Peruvian (cinchona) bark, half a tea-spoonful several times daily to a child), and sometimes wine are needed.
B. For chronic Paint the part with iodine, or use small blisters. If the disease be due to scrofula, cod-liver oil is necessary, or chemical food ; if to syphilis, it must be treated as for syphilis. For both syphilitic and rheu matic periostitis probably iodide of potassium will be best; and it may be given in five to ten grain doses in water twice or thrice daily (for an adult). If a collection of matter has formed, which deep-seated constant pain will indicate, the only remedy is an incision to let out the matter. This cannot be done by inex perienced persons.
Inflammation confined to Inner Lining Membrane (Endostitis, Osteomyelitis, ffedul litis).—This is a rare affection, and when it does occur it is generally after amputations, or owing to bullets, &c., being lodged in the cavity of the bone.