244 Diseases of Bone. 



right tibia, with fibula attached— macerated, showing the 

 above. 



" Charles Anderson, xt. 31. In summer 1814, while on a voyage 

 to the Baltic, he fell on deck with his leg under him. This fall was 

 followed by great swelling below the knee and inability to use the limb. 

 On getting into Riga, ten days after, he was carried to a surgeon, who 

 considered the injury as slight, and gave him a liniment to rub with. 

 He continued this for about a week, and got a little better, so as to be 

 able to walk on crutches — though not to put his foot to the ground — 

 when he had a second fall in crossing the street. He was now carried to 

 a Hospital in Riga, where he was told that the bones below the knee 

 were splintered into several pieces, and was confined to bed for six 

 weeks. He then left the Hospital and came home, still quite unable to 

 walk, and the swelling as great as ever. In winter 1815-16 he was in the 

 Edinburgh Infirmary for about a fortnight, when amputation was pro- 

 posed, but to this he would not consent. In spring 1817, the swelling, 

 which at this time appears to have been only partially ossified, was cut 

 into by a surgeon in Dundee, and discharged a little bloody pus, but 

 soon healed up. In winter 1817-18 he had a severe fever, during which 

 an opening formed where the incision had been made. After liis recovery 

 from the fever, he felt the limb much stronger than it had ever been 

 since the accident, and was soon able to walk. Since then the sore has 

 continued open, discharging commonly a bloody serum, sometimes mixed 

 with blood and purulent matter, and at different times portions of 

 splintered bone, which, he says, could be seen, for months before being 

 discharged, imbedded in the osseous walls of the cavity. The discharge 

 at first was not great, but has gradually increased to eight, twelve, and 

 sometimes even sixteen ounces in twenty-four hours. When he began to 

 walk, he was obliged to use a plug of wood and tow, at first small, but 

 gradually enlarged as the aperture increased to its present size. This 

 he removed once or twice a day, and discharged the fluid from the 

 cavity, which was then washed out, and filled with tow or sponge. His 

 health for the last twelve years had been good, till within six or eight 

 months of this time, when hectic symptoms began to appear, with increased 

 discharge and pain after unusual exertion or exposure to cold. Since 1820 

 he has been employed as clerk to a manufacturer, when he often had 

 occasion to exert himself considerably in weighing flax, and was able to 

 use the diseased limb nearly as well as the other, and has sometimes 

 walked upwards of twenty-four miles in one day." 



Note by Dr E. Knox. — "On examining the limb . . . 

 the following appearances were noted : an extensive swelling 

 or tumonr occupying the superior third of the leg, and extend- 

 ing from close to the knee-joint downwards. This tumour 

 seemed to be composed of an osseous sheet, formed apparently 

 at the expense of the tibia, as the fibula could be traced from 



