A system of surgery . exact cause of thismost interesting disease. It is knownto be an acute infective disease, andbelieved to be due to the invasion ofpyogenic organisms, which must in thatcase be supposed to act with a specialvirulence and through the blood. Or itmay be that the vitality of the tissuesis lowered by some local and trivialinjury, and unable successfully to resistthe invasion. By experiments on ani-mals it has been shown that a simplefracture may be made to suppurate byfeeding the animal on putrid meat. Thedisease is most common in young andgrowing boys between eight and eighte
A system of surgery . exact cause of thismost interesting disease. It is knownto be an acute infective disease, andbelieved to be due to the invasion ofpyogenic organisms, which must in thatcase be supposed to act with a specialvirulence and through the blood. Or itmay be that the vitality of the tissuesis lowered by some local and trivialinjury, and unable successfully to resistthe invasion. By experiments on ani-mals it has been shown that a simplefracture may be made to suppurate byfeeding the animal on putrid meat. Thedisease is most common in young andgrowing boys between eight and eighteenyears of age. Some slight injury appearsoftentimes to be the immediate excitingcause, but it is frequently so slight as tohave been scarcely noticed, and mayeven be entirely forgotten. Those thatare rather feeble and delicate or ill-nourished seem more liable to be at-tacked than the strong and healthy. Symptoms.—Shivering, or even arigor, with a temperature of 102° to 104°Fahr., may usher in the attack. General. Fig. 332.—Acute Necro-sis of a Tibia in whichboth the Diaphysisand lower Epiphysishave been involved,with consequent de-struction of the AnkleJoint. (St. ThomassHospital Museum, ) 878 DISEASES OF BONES. malaise, headache, loss of appetite, and even vomiting and diarrhoea,may also be present. For a time the patient often makes no complaintof any local trouble, and is thought to be sickening for some acutespecific fever. In a day or two, however, the doctors attention isdrawn to an acutely tender and swollen part. A difficulty nowarises as to whether this is due to acute rheumatism, cellulitis, oracute diffuse periostitis. Cellulitis may, as a rule, be excluded ifthere be no wound of the surface for the entrance of infectiveorganisms ?, and if there be such a wound, the inflammation rapidlyspreads in all directions, beyond the next joint and over the adjoin-ing bone. The tender swelling in the disease now under considera-tion is likely to be situated over
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