Relief of Symptoms.—­For the relief of pain, rest is essential.  The inflamed part should be placed in a splint or other appliance which will prevent movement, and steps must be taken to reduce its functional activity as far as possible.  Locally, warm and moist dressings, such as a poultice or fomentation, may be used.  To make a fomentation, a piece of flannel or lint is wrung out of very hot water or antiseptic lotion and applied under a sheet of mackintosh.  Fomentations should be renewed as often as they cool.  An ordinary india-rubber bag filled with hot water and fixed over the fomentation, by retaining the heat, obviates the necessity of frequently changing the application.  The addition of a few drops of laudanum sprinkled on the flannel has a soothing effect.  Lead and opium lotion is a useful, soothing application employed as a fomentation.  We prefer the application of lint soaked in a 10 per cent. aqueous or glycerine solution of ichthyol, or smeared with ichthyol ointment (1 in 3).  Belladonna and glycerine, equal parts, may be used.

Dry cold obtained by means of icebags, or by Leiter’s lead tubes through which a continuous stream of ice-cold water is kept flowing, is sometimes soothing to the patient, but when the vessels in the inflamed part are greatly congested its use is attended with considerable risk, as it not only contracts the arterioles supplying the part, but also diminishes the outflow of venous blood, and so may determine gangrene of tissues already devitalised.

A milder form of employing cold is by means of evaporating lotions:  a thin piece of lint or gauze is applied over the inflamed part and kept constantly moist with the lotion, the dressing being left freely exposed to allow of continuous evaporation.  A useful evaporating lotion is made up as follows:  take of chloride of ammonium, half an ounce; rectified spirit, one ounce; and water, seven ounces.

The administration of opiates may be necessary for the relief of pain.

The accumulation of an excessive amount of inflammatory exudate may endanger the vitality of the tissues by pressing on the blood vessels to such an extent as to cause stasis, and by concentrating the local action of the toxins.  Under such conditions the tension should be relieved and the exudate with its contained toxins removed by making an incision into the inflamed tissues, and applying a suction bell.  When the exudate has collected in a synovial cavity, such as a joint or bursa, it may be withdrawn by means of a trocar and cannula.  There are other methods of withdrawing blood and exudate from an inflamed area, for example by leeches or wet-cupping, but they are seldom employed now.

Before applying leeches the part must be thoroughly cleansed, and if the leech is slow to bite, may be smeared with cream.  The leech is retained in position under an inverted wine-glass or wide test-tube till it takes hold.  After it has sucked its fill it usually drops off, having withdrawn a dram or a dram and a half of blood.  If it be desirable to withdraw more blood, hot fomentations should be applied to the bite.  As it is sometimes necessary to employ considerable pressure to stop the bleeding, leeches should, if possible, be applied over a bone which will furnish the necessary resistance.  The use of styptics may be called for.