Excision of Wrist for Ttibcr miosis. 485 



d. Results of operations for tubercular disease of the wrist. 



7. 154. Return of Tuberculosis after Excision of the 



Wrist.— Section of a left wrist, after excision— in spirit. 



"The sinuses on the dorsum continued to discharge, and as the' 

 patient— a young woman— was suffering in general health, the arm was 

 aininitated." 



Fibrous tissue occupies the place of the carpal bones, but 

 within it there are tubercular foci, with which the sinuses 

 communicate, and which account for the continued discharge. 



G. C. 3301. 



Presented by A. G. Miller. F.R.C.S.E., 1891. 



7. 155. Return of Tuberculosis after Excision of the 



Wrist. — Section of the radius, with middle metacarpal bone 

 and phalanges, from the previous case — macerated. 



There is enlargement of the lower end of the radius by 

 new periosteal formation, and the new bone itself is partly 

 eroded near the lower end. G. C. 3302. 



Presented by A. G. Miller, F.R.G.S.E. 



3. Changes — Inflammatory and otherwise— due to the disease 



known as " Arthritis deformans," " Chronic Bheumatic 



Arthritis," "Poor Mans Goiit" ete. 



* KNEE-JOINT. 



7. 156. Early Stag"e of Arthritis Deformans.— Lower end 



of a left femur and patella from an old man — injected with 

 carmine, and in spirit, showing changes chiefly in the patella. 



The patient was a rather done man of 56, whose lower limb was 

 amputated above the knee for a compound fracture of the leg. 



Across the patella the cartilage is deeply furrowed, the 



* The knee-joint is taken first, because the early stages of the disease are 

 better illustrated in this Museum by the specimens of that joint than by those 

 of any other. 



