Tubercular Enlargement. 285 



The sclerosed condition of the femur is a striking contrast 

 to that of the tibia, which is, if anything, atrophied. The 

 cavities in this half of the femur correspond to those previously 

 noticed in the other half. The periosteal surface of the femur 

 shows irregularity from a deposit of new bone. G. C. 3216. 



6. 216. Tubercular Enlarg-ement of the Shaft of the 



Femur. — Section of the lower end of a right femur — macerated, 

 illustrating the above. 



" The patient was a woman aged 40. She had long complained of a 

 deep-seated pain in and near the knee-joint, for which she had been 

 blistered, bnt without much beneiit. She died of phthisis pulmonalis." 



The specimen shows a combination of erosion with new 

 bone formation. The erosion is seen partly in the interior, 

 where the cancellous tissue is destroyed, and partly on the 

 surface, near the lower end, where there are pits and irregular 

 excavations. The new bone formation is seen as an irregular 

 crust on the surface of the lower end of the shaft, resembling 

 the crust due to the irritation of pus-forming organisms. 



G. C. 858. 

 Presented by Sir George Ballingall. 



6. 217. Tubercular Enlargement of the Shaft of the 



Femur. — Other half of the previous preparation — in spirit, 

 illustrating the above. 



The spaces in the interior of the bone are occupied by 

 granulation tissue, shrivelled up by the spirit. On the surface 

 similar material has been left in one or two places. G, C. 858 a. 

 Presented by Sir John Ballingall. 



c. Where the chief changes are in the form of necrosis, combined with 

 absorption or enlargement, or both. 



6. 218. Tubercular Disease of the Head of the Tibia.- 



Upper end of a left tibia — macerated, illustrating the above. 



