Caries from Pus-formi'ng Organisms. 237 



trochanter has been reduced to a thin shell, existing only on 

 the outer side. This has been fractured, possibly in the process 

 of preparation. Below the seat of fracture some new periosteal 

 bone has been thrown out on the surface. This has evidently 

 been a case of advancing septic inflammation. 



B. C. 2. M. 4. 



6. 86. Acute Suppurative Inflammation of the Cranium.— 



Lower half of a cranium, lower jaw and first three cervical 

 vertebrae — macerated, showing the above. 



The patient, an old lady aged 75 years, had suffered from a most 

 severe attack of erysipelas of the face and head, accompanied by very 

 great oedema and swelling of the soft parts, and followed by their destruc- 

 tion. Caries soon occurred on the mastoid process, and rapidly spread to 

 the neighbouring bone. Ere long the carotid artery was laid bare, and 

 was seen pulsating against a sharp portion of the petrous portion of the 

 temporal bone. It ruptured in a day or two, and fearful htemorrhage 

 occurred. Dr Foulis at once stuffed up the large hole which had been 

 formed in the side of the head by the destruction of the soft parts and 

 bone with a lump of cotton wadding. This stopped the bleeding, and 

 the lady lived for four days afterwards. 



The squamous and mastoid portions of the temporal bone, 

 with the great wing and outer ptergyoid plate of the sphenoid 

 as well as the condyle of the lower jaw, have disappeared. The 

 surfaces of bone which lay next to the missing parts are rarefied 

 and absorbed. The vertebras have evidently been injured in 

 being removed, but parts of their surface have also been attacked 

 by the disease. G- C. 2647. 



Frese7ited hj J AWES Fotjlis, M.D. 



6. 87. Acute Suppurative Inflammation of the Sternum 



leading" to Destruction. — Lower end of a sternum and 

 costal cartilages, showing the above. 



The specimen was obtained from a patient who died in the Royal 

 Infirmary, Edinburgh, in 1824, after a head injury, for which trephining 

 had been performed. The cause of death was therefore probably jiya^mia, 

 in the course of which an abscess had formed in the sternum. 



