. Modern surgery, general and operative. n somecases chilling of the surface of the body is a predisposing cause. In others nopredisposing cause is discoverable. The compact bone suffers secondarily, but is never attacked tissue is more susceptible to infection than old tissue, and the disease,as a rule, begins near the epiphyseal line, where new bone is being point was spoken of by Oilier as the zone of election of pathologicalprocesses. Warren points out that in a growing bone near the epiphysealcartilage there exists a newly formed spongy tissue, very vascular and
. Modern surgery, general and operative. n somecases chilling of the surface of the body is a predisposing cause. In others nopredisposing cause is discoverable. The compact bone suffers secondarily, but is never attacked tissue is more susceptible to infection than old tissue, and the disease,as a rule, begins near the epiphyseal line, where new bone is being point was spoken of by Oilier as the zone of election of pathologicalprocesses. Warren points out that in a growing bone near the epiphysealcartilage there exists a newly formed spongy tissue, very vascular and connectedwith the cartilage by a spongy layer of tissue, which is not yet bone, but whichdoes not possess a cartilaginous structure. It is in this portion of the skeletonthat the most active changes take place during the period of growth. Themedullary substance is very vascular atthis point; it is red and without fattytissue. It communicates with the me-dullary canal and with the periosteum ^^^H ? ? 1 ^i^ ^^^H K ^^ *^ ? * ^ ^ 1 1^. Fig. 289.—Fracture of femur after acute os-teomyelitis. Fig. 290.—Osteomyelitis, showing sequestrumformation. by a number of vascular channels. The epiphyseal cartilage itself is inti-mately blended with the periosteum. The diaphyseal side of the cartilageproduces much more bone than is found in the epiphyseal margin. There isalso an active growth of bone in the periosteum, and it is in these regionsand in the medullary canal that the inflammatory process originates.^ Theend of the diaphysis is very vascular, but the blood-stream is sluggish becauseof the large size of the capillary loops (Practice of Surgery by Spencerand Gask). The lower end of the femur and the upper end of the tibia are theregions most commonly attacked; but the upper end of the femur and thelower end of the tibia may suffer, and other bones may be attacked, especiallythe humerus, radius, ulna, and inferior maxilla. The adjacent joint not unusu-ally becomes involved. Though t
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