474 Diseases of Joints. 



The adjacent surfaces of the astragalus and tibia are 

 remarkable for showing a hard and eburnated portion of the 

 articular surface, while the rest is rarefied and eroded. The 

 surfaces of the astragalo-scaphoid joint are very rough and 

 irregular, as are also those of the joints between the astragalus 

 and OS calcis. These three bones are also lightened and eroded 

 interiorly. The joint between the os calcis and the cuboid has 

 been affected, but to a less extent, while the cuneiform bones 

 seem intact. The articular surface of the fibula is eroded, and 

 shows a few pieces of smooth bone. A slight crust of new 

 periosteal bone has been formed at the lower ends of the tibia 

 and fibula, as if from septic complication. G. C. 906. 



Referred to in Sir George' Ballingall's Clinical Lectures, No. 1, page 7. 

 Presented by Sir Georgk Ballingall. 



7. 125. Tubercular Disease of Tarsus and Metatarsus. 



— Several of the left tarsal and metatarsal bones of a young 

 person — macerated, illustrating the above. 



There are tubercular changes in several of the bones. 

 The shaft of two of the metatarsal bones are enlarged, and 

 their interiors are hollowed out, and several other bones are 

 rarefied and partially absorbed. G. C. 940. 



7. 126. Disease of Tarsus, possibly Tubercular, but chiefly 



Septic— Lower end of the right tibia and fibula, astragalus, 

 OS calcis, first, fourth, and fifth metatarsal bones, and some 

 phalanges of a child — macerated, illustrating the above. 



John Carlan, aged 3, was admitted to the Royal Infirmary, Edin- 

 burgh, on 8rd July 1827, suffering from extensive ulceration over the 

 malleoli of the right leg. The tibia and fibula were bare, and the ankle- 

 joint exposed. Four weeks previously he had received some injury 

 which, after three weeks, had ended in an abscess. Owing to increased 

 discharge, with diarrhoea, the leg was amputated, but the patient died 

 within a week. The astragalus was found loose, "embedded in pus," 

 and the lower end of the fibula was covered with granulations. 



