258 Diseases of Bone. 



case of new bone. This is deficient along the front, and not 

 well formed anywhere. The surface of the sequestrum has been 

 blackened. E. C. i. 5. M. 38. 



6. 130. Acute Suppurative Osteo-myelitis of the Tibia— 



NeCFOSis. — Right tibia — macerated, illustrating the above. 



There has been more or less complete necrosis of the shaft 

 from end to end. The sequestrum has been separated from the 

 remains of the original bone, and new periosteal bone has been 

 developed round it. The new shell, however, is so imperfect 

 that the greater part of the sequestrum is exposed. There is an 

 oval aperture with rounded margins low down on the inner 

 side of the new case, tlie nature of which is obscure ; possibly 

 it was made by a surgeon. B. C. i. 5. M. 42. 



6. 131. Acute Suppurative Osteo-myelitis of the Tibia- 

 Necrosis, Imperfect Regeneration, Enlargfementofthe 



Fibula. — Right fibula and portions of tibia of a young person 

 — macerated, illustrating the above. 



"The disease had affected the leg for nine years." Amputation 

 was performed with success. " The lower part of the tibia had become 

 .soft and spongy ; the periosteum was much thickened at the diseased 

 parts ; there was extensive ulceration of the soft parts." 



A portion, nearly three inches in length, is wanting from the 

 lower end of the shaft of the tibia. The upper fragment of the 

 tibia is for the most part irregular, but the surfaces are smoothed 

 over. The upper end of the lower fragment is much rarefied. 

 The fibula is much thickened, especially near the middle, by 

 irregular deposits of bone on the surface. Opposite the 

 deficiency in the tibia, however, the surface of the fibula is 

 rarefied and has been partly absorbed. 



Probably in this case there has originally been septic osteo- 

 myelitis and necrosis, followed by a foul-spreading ulcer. This 



