White-Swelling is a tumor of the joints, but chiefly of the knee: at first, it is not perceptibly enlarged; being of the same colour as the skin; very painful, and diminishing the power of motion. - There are two species of this disorder; namely, the rheumatic, and scrophulous. As it is of the first consequence to distinguish these maladies, the origin of which is essentially different, we shall state the symptoms peculiar to each.
The rheumatic white-swelling is attended with acute pain over the whole joint; and which is increased by heat: the patient finds the greatest relief in a relaxed position; the tendons become rigid ; and the joint appears as if the bones were enlarged. The tumor increases to three or four times the size of the knee, and feels elastic to the touch ; while the limb decreases, or sometimes becomes dropsical: at length, abscesses are formed ; discharging matter which soon degenerates into a fetid ichor. Unless, therefore, a cure be timely effected, the patient is attacked with a hectic fever, which generally clones the scene of misery.
In the scrophulous kind, the pain is more acute, and confined to one spot: as the disorder gains ground, the swelling, and stiffness increase, while the ends of the bones become visibly enlarged. Similar elasticity is perceivable, and abscesses are likewise formed ; which, on being opened, discharge an offensive humour ; the bones decay, and pieces are often ejected through the orifices of the wounds. The adjacent parts become progressively affected, till the sufferings of the patient are also terminated by the hectic fever.
As the distinction above pointed out, sufficiently explains the proximate causes, we shall only mention those which occasionally occur; and the principal of which are, suppressed perspiration; injudicious treatment of cutaneous disorders ; especially of the measles, small-pox, rose, etc.; external violence, such as falls, blows, and frequent kneeling.
Cure: - In the rheumatic white-swelling, which, at first, is of an inflammatory nature, it will be advisable to adopt a cooling regimen. Farther, blood should be taken from the diseased part, by cupping or scarification; a practice which is far preferable either to venesection or to the application of leeches; and it may be repeated according to the strength of the patient, and urgency of the symptoms. Next, a blister must be applied to the opposite side, and kept open, till the scarified part is healed.
Internally, mild cooling laxatives should be occasionally taken, and heating liquors, as well as coarse food, must be strictly avoided. If a stiffness of the knee remain, after the swelling has subsided, great benefit will be derived from the application of pure, warm olive oil, and from gentle frictions, repeated three or four times every day. - But, where suppuration has already taken place (which may be ascertained by the softness of the tumor); or, if the disorder make rapid progress, professional advice should be speedily procured.
In the scrophulous white-swelling, the treatment specified under the head of Scrophula, should be resorted to without delay. - When this affection is confined to the smaller joints, it has by those means, been sometimes cured; but, when the larger joints, for instance, the knee, ancle, etc. are thus diseased, amputation is the only remedy. If, however, the whole system be tainted with a scrophulous acrimony, even that operation is frequently ineffectual.