426 Diseases of Joints. 



fluid. On making a small incision into the abscess, much gas, smelling 

 of sulphuretted hydrogen, came away, with a thin, foetid, greenish-coloured 

 pus. Two daj^s after admission two incisions were made into the abscess in 

 the shoulder. The joint could be felt exposed, by a large ulcerated opening 

 through the capsular ligament. A very large abscess was opened soon after 

 in the lower part of the arm, and greenish matter, thin and foetid, 

 was discharged. 



The opening into the upper part of the joint has been 

 artificially enlarged. The cartilage at the margin of the arti- 

 cular surface has disappeared, leaving the bone exposed below. 

 An early stage of the same process is seen at the middle of 

 the head of the humerus. G. C. 1199. 



Presented by Adam Hunter, F.R.C.S.E., 1828. 



7. 5. Suppurative Osteo-myelitis of the Head of the 

 Humerus, involving- the Shoulder-joint. — Upper end of 



the left humerus of a child — in spirit, illustrating the above. 



"The patient was a fine little boy of two years. While amusing 

 itself at its mother's foot about two months previously, it stumbled, and 

 was falling forward, when the mother caught hold of the left arm, by 

 which indeed she prevented the fall, but unfortunately injured the 

 shoulder-joint severely. The joint soon after swelled and became 

 inflamed, and an abscess forming, considerable discharge took place. 

 The donor of the preparation, when first consulted, probed the sore, and 

 found the bone carious, but made a free incision in the hopes that nature 

 would eff"ect a cure. This did not take place, and the child's health 

 appearing to be rapidly sufl'ering, the removal of the bone was determined 

 on. The case seemed doing well for a few days, but a violent attack of 

 erysipelas supervened, from which he never recovered, but died in about 

 a fortnight after the removal of the carious bone. 



"The internal structure of the bone was found nearly destroyed. 

 A few small pieces were found floating in the cavit}\ The cartilages of 

 the joint were found during the operation to have been partially 

 anchylosed. An exceedingly small quantity of blood v,-as lost by the 

 patient during the operation." 



The specimen shows a large cavity in the head of the 

 bone, containing a loose, necrosed fragment. G. C. 1199. 



Presented by Adam Hunter, F.R.C.S.E., 1828. 



7. 6. Suppurative Osteo-myelitis of the Femur, involving- 



