280 Diseases of Bone. 



6. 201. Sequestrum from the Skull due to Septic Osteo- 

 myelitis following- Injury. 



The bone was " denuded of periosteum by accident and subsequently 

 thrown off." 



The bone is exceedingly irregular and eaten out by the 

 action of granulations. G. C. 1168. 



4. * Infiammation of Bone 'produced hy the Tuhercle Bacillus. 



a. Where the chief changes are in the form of rarefaction and absorption, 

 i.e., a tubercular form of caries. 



6. 202. Tubercular Disease of Carpal and Metacarpal 



Bones. — Section of part of the right hand of a woman — 

 injected, and in spirit, showing the above. 



Mary A., let. 26, Shetlander, had a tubercular appearance and 

 family history. Six months before coming to Hospital she liad "acute 

 rheumatism " (tuberculosis ?) which did not affect the joints of the 

 right wrist, although it attacked almost all her other joints. She 

 believed she had twisted this wrist while turning in bed when suffering 

 from the "rheumatism." The wrist and hand gradually became swollen, 

 painful, and unnaturally movable. Fluctuation ensued. Amputation was 

 performed above the wrist. A week later she had severe pain in her 

 head. There was no phthisis, but death occurred shortly afterwards from 

 general tuberculosis. No post-mortem examination was obtained. 



There are caseous deposits in many of the carpal bones 

 and in the bases of the metacarpals. Some of these centres 

 are surrounded by a vascular area, and in some cases the 

 caseation has spread from one adjacent bone to another. At 

 some places the bones are softened, vascular, and broken down. 

 In many places the cartilage has disappeared, having been 

 chiefly attacked from within. 



The non -vascular portion of the radial side of the unciform 

 consists of hard dense bone, in the others the non-vascular 

 portion is caseous and soft. G. C. 3072. 



Presented hy A. G. Miller, F.R.C.S.E., 1889. 



6. 203. Tubercular Disease of the Sternum.— Sternum of a 



* See series 7 for other examples of tubercular disease of bone. 



