Suppurative Arthritis. 427 



the Knee-joint. — Lower end of a right femur, with the 

 articular end of tibia — in spirit, illustrating the above. 



"From a patient in the Royal Infirmary, 26 years of age. Seven 

 years previously an abscess formed and discharged at the outside of the 

 thigh, when several portions of the bone came away. Two months before 

 amputation the bone became affected with severe pain. After his 

 admission to the Hospital, which was five weeks after the commencement 

 of this attack, several ounces of purulent matter were discharged from the 

 outer and upper part of the knee. His general health was much affected. 

 He had a quick pulse, flushings, diarrhoea, and morning sweats. Ampu- 

 tation was performed ; these subsided, and he recovered, so that he left 

 the Hospital well in four weeks." 



The specimen shows considerable thickening on the surface 

 of the lower end of the femur, with, in addition, on the back 

 and outer sides, apertures leading into the bone, and on the 

 outside a small necrosed fragment in process of separation. 

 The articular surface of the femur shows several patches of 

 bare necrosed bone, like islands in the cartilage ; these, though 

 unchanged on the surface, seem loosened from below. The 

 changes on the patella are superficial. 



This seems to have been primarily a case of osteo-myelitis, 

 extending afterwards to the joint. G. C. 2232. 



Presc/JtoZ 6?/ Alexander Watson, F.R.C.S.E., 1838. 



7. 7. Suppurative Osteo-Myelitis of the Femur, involving* 



the Knee-joint. — Lower end of the riglit femur of a young 

 person — macerated, showing changes similar to those in the 

 previous specimen. 



This one was originally entered in the Catalogue as a case 

 of white swelling, but it is more like the above. On the 

 popliteal surface of the femur, white necrotic fragments of 

 bone are seen, and below them the original bone is rarefied, 

 while higher up, and extending round to the front, there is a 

 considerable development of new periosteal bone. The articular 

 surface on the inner condyle of the femur shows a bare necrotic 

 patch, surrounded by rarefied, partially absorbed bone tissue. 

 One or two roughened patches are seen on other parts of the 

 articular surface. G. C. 372. 



