distinct, but in some parts cancellated quite to the surface. No trace of a cavity. Epiphyses not co-ossified. 1847.
Dr. J. C. Warren.
1238. Chronic inflammation of the tibia. From a man set. twenty- seven, who injured his leg nineteen years before entrance into the hospital (126, 274). Inflammation followed, and for the first six years there was an occasional discharge of bone. Had done no work for the last six months. On ad- mission, the knee was bent to a right angle ; bone enlarged and bovred inward ; skin tense, discolored and cicatrized ; discharge profuse, and through the openings dead bone was felt. Dr. H. amputated above the knee, and in seven weeks the man was discharged, but with some inflammation of the stump, and dead bone ; his general health having never been good.
The bone is enlarged throughout. Upper half mostly diseased, and especially toward the back ; being very rough from caries, and with small pieces of dead but not loose bone. 1867. Dr. M. M. Hodges.
1239. Old disease of the tibia, from a man set. fifty-eight, who entered the hospital Feb. 14th, 1868 (134, 184). When about twelve years old he injured his leg, and there was swelling from that time. Twelve years before entrance he had compound fracture of both bones of the leg, and at the seat of injury, which was about the junction of the middle and lower thirds. In four years the limb was sound, but three years afterwards a small sore formed, and kept open from that time. Five weeks before admission the leg became much swollen, painful, red, and cedematous ; and three days afterward the sore increased and the discharge became abundant ; the leg, on admission, being twice the size of the other, and with a foul ulcer upon it, of which the diseased tibia formed the base.
On the 15th, Dr. B. removed the diseased bone, some of which was excessively hard ; and on the 12th of March the man left the hospital.
Sept. 22d, he was readmitted with a deep and defined ex- cavation at the seat of disease, 3 in. in length and 1 in. ia width. The wound had never quite healed, and the sur-
�� �
