f about ten days I considered my patient
convalescent. About this time I was sent for in great haste after night.
The patient, who is a very intelligent man, said he had felt worse during
the day, and in the evening, his knee, which had been somewhat painful for
two or three days, had become exceedingly painful. I gave morphine,
hypodermically, and went home, leaving some morphine for the night.

The next day I saw him. The pain had been relieved by the morphine, still
occasionally it was quite severe. There was no redness or heat, or even
tenderness; nothing unnatural about the knee except pain, which was
aggravated by any attempt to move the leg.

Ordered quinine as a tonic, and pill "C. C." as a cathartic. Bandaged the
leg pretty tightly from the toes to above the knee. The urine was natural;
pulse and temperature only slightly elevated. After six or seven days of
these symptoms, the knee began to feel hot and became very slightly
swollen. Ordered a small blister over the inside of the knee as the
greatest amount of pain seemed to be here. Dressed it with tartar-emetic
ointment until the skin was very sore; using iodine on other puts of the
knee. Used iodide potassium and colchicum, internally. This treatment for
five days seemed to do no good. On Jan. 17th, twenty-two days from the
beginning of his illness, and about twelve days from the first appearance
of symptoms denoting any local trouble at the knee, a consultation was
held, the result of which was a blister over the whole of the knee, to
be dressed with unguentuin hydrargiri. The inflammation was but little
influenced by this or any other treatment. The knee continued to slowly
and surely enlarge. And this extended upward without first producing any
great distention of the synovial sack under the patella. There seemed to
be simply enlargement of all the tissues of the lower part of the thigh.
This continued until about the 1st of Feb. when, from the general
appearance of the patient, viz: a typhoid condition, feeble pulse, coated
tongue, emaciation, loss of appetite, as well as from the local appearance
of the inside of the knee, I suspected pus within the joint. Accordingly,
I introduced an exploring needle into the inner part of the joint just
above and anterior to the insertion of the tendon of the semimembranosis
muscle. Finding pus, I made an incision only about half an inch long, and
squeezed out perhaps an ounce of pus. Closed this up and again bandaged