Necrosis from Fiis-forming Organisms. 253 



knee becomes very delicate, and. at the knee there is practically 

 no bone at all. The bone forming the upper end of the tibia is 

 reduced to a shell with numerous apertures in it. The shaft of 

 the tibia is also reduced to a hollow and fragile shell, which in 

 many places is perforated by apertures. The contrast between 

 the atrophy of the tibia and the new bone development round the 

 sequestrum in the femur is very striking. G. C. 3499. 



Trcsented hy Alexis Thom.sox, F.R.C.S.E., 1893. 



6. 117. Acute Suppurative Osteo-myelitis of the Femur- 

 Necrosis, Anchylosis of the Knee, and Atrophy of the 



Tibia. — Water-colour drawing by John T. Kelly of the previous 

 specimen, when fresh. 



The drawing shows the enlargement of the femur, and the 

 sequestrum lying in its cavity surrounded by grey gelatinous 

 material. Near the lower end of the shaft of the femur the 

 new bone is shown opened out in texture and the epiphysis and 

 adjacent part of the shaft entirely occupied by a brown fatty 

 material. The same substance is seen in the section of the 

 patella and tibia. The cancellated tissue in the tibia is entirely 

 absorbed and the bony shell is very thin. The muscles round 

 the bone were very soft and fatty. G. C. 3500. 



6. 118. Acute Suppurative Osteomyelitis of the Femur- 

 Necrosis, Amputation. — Sequestrum of the lower portion 

 of a femur, partially surrounded by a shell of new bone — 

 macerated, to show the above. 



The disease began in the knee-joint. A partial case of new bone 

 has formed round it. The surgeon in charge of this patient wished to 

 amputate at the hip-joint, but on Sir Charles Bell's advice, he amputated 

 through the thigh, with complete success. 



The sequestrum, which has included the greater part of 

 the lower end of the shaft, has been completely separated 



