least, it improves under rest.

If the disease is not arrested, there follow the symptoms and signs of
involvement of the articular surfaces.

_Influence of Tuberculous Joint Disease on the General
Health._--Experience shows that the early stages of tuberculous joint
disease are compatible with the appearance of good health. As a rule,
however, and especially if there is mixed infection, the health suffers,
the appetite is impaired, the patient is easily tired, and there may be
some loss of weight.

#Treatment.#--In addition to the general treatment of tuberculosis,
local measures are employed. These may be described under two heads--the
conservative and the operative.

_Conservative treatment_ is almost always to be employed in the first
instance, as by it a larger proportion of cures is obtained with a
smaller mortality and with better functional results than by operation.

_Treatment by rest_ implies the immobilisation of the diseased limb
until pain and tenderness have disappeared. The attitude in which the
limb is immobilised should be that in which, in the event of subsequent
stiffness, it will be most serviceable to the patient. Immobilisation
may be secured by bandages, splints, extension, or other apparatus.
_Extension_ with weight and pulley is of value in securing rest,
especially in disease of the hip or knee; it eliminates muscular spasm,
relieves pain and startings at night, and prevents abnormal attitudes of
the limb. If, when the patient first comes under observation, the limb
is in a deformed attitude which does not readily yield to extension, the
deformity should be corrected under an anaesthetic.

_The induction of hyperaemia_ is often helpful, the rubber bandage or the
hot-air chamber being employed for an hour or so morning and evening.

_Injection of Iodoform._--This is carried out on the same lines as have
been described for tuberculous abscess. After the fluid contents of the
joint are withdrawn, the iodoform is injected; and this may require to
be repeated in a month or six weeks.

After the injection of iodoform there is usually considerable reaction,
attended with fever (101 F.), headache, and malaise, and considerable
pain and swelling of the joint. In some cases there is sickness, and
there may be blood pigment in the urine. The severity of these phenomena
diminishes with each subsequent injection.

The use of Scott's dressing and of blisters and of the actual cautery
has largely