1299. Extensive necrosis of cancellated structure of the upper part of the tibia. From a man twenty-four years of age. (Hospital, 89, 208.) For the last fourteen years he had been subject every three or four years to attacks of pain, swelling, abscess, and discharge of bone. Ten days before admission one of these attacks came on, and the pain was intense, with delirium; dead bone felt; discharge free and offensive. A piece of bone 2½ by ¾ in. was removed, and he died five days afterward.
The upper half of the tibia becomes, gradually, much enlarged near the head; the surface is destroyed to a considerable depth, and exposes a large portion of the cancellated structure that is nearly separated as dead bone. This last and the surrounding bone is very light and delicate. The outer surface of the tibia is slightly rough and porous, but without any appearance of periosteal deposit. 1861.
1300. Lower portion of the femur, not including the condyles, and showing an extensive and advanced necrosis; the surface and the deeper seated parts of the bone being involved. There is also an abundant, soft, granular, and apparently recent periosteal deposit. 1847. Dr. J. C. Warren.
1301. Lower portion of the radius, removed by M. Velpeau, of Paris, and presented to Dr. W., who happened to be present at the operation. The styloid process seems to be dying, with caries about it, and periosteal deposit upon the surface above it. An acute disease. 1847. Dr. J. C. Warren.
1302. Removal of the entire ulna, from a young man æt. seventeen. He had been in the cavalry service, and his disease was attributed to the hard duty that he performed. During the last week of May, 1866, severe pain came on, followed by swelling; treated as phlegmonous erysipelas, by incicisions; pus evacuated with relief, but the sinuses remained.
Dead bone was felt on his admission into the hospital, July 8th (126, 138); and an opening near the elbow having been enlarged, the whole articulating extremity of the ulna was found loose and was removed. A long incision was then made, and the entire shaft of the bone, with the
