Necrosis from Pus-forming Organisms. 247 



quence of sinking from hectic fever, amputation was performed, but he 

 died two weeks after." 



The specimen shows an area of bare dead bone, with a 

 great thickening and vascularity of the periosteum on what had 

 been living. The dead bone has been pitted on the surface by 

 the vascular granulations, which have been lifted up in many 

 places to show this. Other vascular granulations can be seen 

 here and there coming through the bone from below. At one 

 place there is a narrow grey strip of new periosteal bone. 



This has evidently not been a case of erysipelas, but of the 

 above, a disease often mistaken for it. These cases often die, as 

 this one probably did, of septic poisoning, with or without 

 pyaemic complications. G. C. 2228, 



Prcscnteo? % Alexander Watson, F.R.C.S.E., February 1837. 



6. 104. Acute Suppurative Osteo-myelitis and Periostitis 



of the Tibia — Necrosis. — Tibia of a young person, with 

 adjacent soft parts — mounted in spirit, to illustrate the above. 



The entire shaft has apparently been involved. This 

 specimen resembles the last in the death of portions of the 

 shaft, thickening of the periosteum at other places, and in pit- 

 ting and erosion of the dead parts by the granulations of the 

 living. G. O. 3o52. 



6.105. Acute Suppurative Osteo-myelitis and Periostitis 



of the Tibia— Necrosis.— Section of the upper half of a 

 tibia — injected and mounted in spirit, to illustrate the process of 

 separation of necrosed fragments. 



The disease was started by a blow upon the tibia. "Mr Benjamin 

 Brodie took notes of this case, when the patient was in Hospital (IMiddle- 

 sex) 1806." 



There is a large piece of necrosed bone in front, and other 

 smaller pieces below and behind. The dead parts are indicated 

 by bristles and are whiter than the rest. The process of 



