Inflammation from Pus-forming Organisms. 233 



laid open, and a large quantity of pus, which had burrowed all round the 

 bone, was evacuated. A counter opening behind was made for drainage. 

 Three days afterwards violent haemorrhage occurred from the soft tissues 

 behind the bone, and was checked by plugging. As the boy's pulse and 

 tem]^>erature continued high, the leg was amputated above the knee, one 

 week after his admission. The knee-joint was found to be suppurating. 



The specimen shows almost complete separation of the 

 periosteum, except at the lower and slightly at the upper ends 

 of the tibia. It also illustrates the very free incision required 

 for such cases. The injection failed owing to the numerous 

 points at which escape occurred. G. C. 2788, 



Presented by Professor T. Annandale, F.R.C.S.E. 



6. 79. Acute Suppurative Osteo-myelitis of the Tibia- 

 Amputation. — Section of the injected right tibia of a girl — in 

 spirit, shoAving the above. 



Al)out Christmas 1889, Agnes R. , aged 12 years, blistered a part 

 of her heel, which soon became inflamed and irritable. This was poulticed 

 and then improved. About the 8th of January 1890, her ankle " gave way ' 

 while she was skating, and became afterwards swollen and painful. The 

 swelling, which was at'first near the ankle, afterwards extended to the knee. 

 Shortly afterwards an abscess was opened over the inner malleolus, and 

 speedily others formed, and were opened higher up the leg. Eventually 

 the ankle-joint communicated with one of the abscesses, and the tissues 

 of the leg generally became inflamed. She was admitted to Ward 17, 

 Royal Infirmary, on January 30th, 1890, and shortly afterwards the leg 

 was amputated, just above the knee. A few days later an abscess formed 

 on each shoulder, and that on the left was followed by considerable 

 necrosis of the upper end of the humerus. Similar abscesses formed over 

 each olecranon process. She was greatly emaciated, and after remaining 

 in Hospital for many weeks, was sent to the Incurable Hospital, where 

 she died some weeks afterwards. 



The specimen shows purulent infiltration through nearly 

 the whole of the medullary cavity of the tibia. It also shows 

 new periosteal bone forming on the surface of the shaft, and 

 complete detachment of the lower epiphysis. G. C. 3260. 



Presented hy A. G. Miller, F.R.C.S.E., 1891. 



6. 80. Acute Suppurative Osteo-myelitis of the Tibia- 



