250 Diseases of Bone. 



and ulna — muscles partly cleaned off and in spirit to show the 

 above. 



W. B., a weaver, aged 21, was admitted to the Royal Infirmary, 

 Edinburgh, on 21st May 1824. Fifteen weeks previously the disease 

 began with erysipelas of the part, followed by formation of abscesses in 

 different parts, and of sinuses similar to that now at bend of arm. Some 

 of these have never healed, and he has had two subsequent attacks of 

 erysipelas. Was in the House from March 23rd to April 16th. Dismissed 

 by desire." 



On his second admission, "the whole of the right fore-arm is 

 swelled and particularly tender, especially at the elbow and wrist, where 

 the enlargement is equable and very hard, and where there are sinous 

 openings leading down to the bone. The granulations at the mouths of 

 these are prominent, and there is a fungus forming over the carpus a large 

 irregular unhealthy ulcer. The joints appear anchylosed ; motions of the 

 hand, which is distorted inwards, lost. The attempt to move the hand 

 in any direction attended with great pain. Great general weakness and 

 copious sweating. Pulse 102, firm ; tongue clean ; bowels costive ^ 

 appetite pretty good." 



The arm was amputated by Mr Allan at about two inches above 

 the elbow. The patient did well for three days after the operation, but 

 on the evening of the third day he had severe rigors, followed by profuse 

 sweating and other symptoms of pyaemia, which continued till his death. 

 The stump suppurated extensively. The pus ran up to the shoulder and 

 affected the joint. Patient sank exhausted on the 16tli July. (See No. 

 6.181.) 



The radius is enlarged over its whole extent by develop- 

 ment of new bone on the surface. At the back, near the lower 

 end; there is a large fragment of dead bone, which is free above, 

 but surrounded by a new shell below. The ulna does not 

 appear to have been involved by the disease. G. C- 981. 



6. 113. Acute Suppurative Osteo-myelitis of the Femur — 



Necrosis and Rarefaction. — Left femur — macerated, show- 

 ing the above. 



" The man received a blow from a mallet on the thigh. A deep and 

 large abscess formed. He died. An abscess surrounded the thigh-bone^ 

 which broke when being raised." 



On the posterior portion of the lower end of the shaft there- 

 is a large necrosis, smooth and white, and partially separated 

 from the surrounding bone. The groove of separation is much 

 deeper above than below, where at places it is very indefmite.. 



