Syphilitic and Septic Disease. 333 



A large and very irregular piece of bone on the shin surface 

 has proTbably been exposed on the floor of an ulcer. It is 

 deeply entrenched all round except at the upper end. An 

 aperture on the oblique ridge behind exposes the necrosed bone 

 at the back, but the deep attachments are otherwise still quite 

 firm. The general surface of the shaft is very rough from new 

 periosteal formation. At the lower end the inner and posterior 

 surfaces are greatly eroded, and show apparently a necrosis of 

 the interior, which has extended to the outer part of the 

 articular surface. The fibula is unchanged, with the exception 

 of a new periosteal deposit on the surfaces adjacent to the tibia. 



F. P. C. 447. 

 Presented by Professor John Thomson. 



6. 344. Syphilitic (Mercurial ?) Disease of the Tibia, with 



Necrosis. — Left tibia and fibula from the same patient as the 

 last — macerated, illustrating the above. 



There are two partially separated necroses — one just above 

 the middle, distinctly entrenched round but still adherent ; the 

 other above the lower end, much rougher on its surface, and less 

 distinctly entrenched below, where it merges 'into a carious 

 condition of the surrounding bone. The rest of the tibia is 

 thickened by new periosteal bone, with a porous surface. The 

 lower articular surface of the tibia is affected apparently by 

 necrosis of the bone over an area corresponding to that on the 

 right side but less advanced. The upper articular surface is 

 unchanged. This fibula, like the right one, is comparatively 

 unchanged. F. P. C. 448. 



Presented by Professor John Thomson. 



6. 345. Syphilitic (Mercurial?) Disease of the Tibia, with 



Necrosis. — A right tibia in section — macerated, illustrating 

 the above. 



