American practice of surgery : a complete system of the science and art of surgery . or acute necrosis may be briefly and comprehensively defined as follows: Itis an acute, inflammatory disease of pyogenic origin occurring principally inthe long bones of young people in whom the union of the diaphyses and epiphyseshas not yet taken place. It occurs usually in those who have been depressedby antecedent disease or who have been exposed to inclement weather or toinjury, and is marked, as a rule, by profound symptoms, both locally and con-stitutionally. It is liable to be complicated by acute ulce
American practice of surgery : a complete system of the science and art of surgery . or acute necrosis may be briefly and comprehensively defined as follows: Itis an acute, inflammatory disease of pyogenic origin occurring principally inthe long bones of young people in whom the union of the diaphyses and epiphyseshas not yet taken place. It occurs usually in those who have been depressedby antecedent disease or who have been exposed to inclement weather or toinjury, and is marked, as a rule, by profound symptoms, both locally and con-stitutionally. It is liable to be complicated by acute ulcerative endocarditis,or by suppurative inflammation of the serous cavities (such as the pericardiumand pleura), and almost always results in massive necrosis or death of a greateror less area of the affected bones. Etiology.—Though acute osteomyelitis is undoubtedly a germ disease,there are certain conditions of environment, antecedent disease, and local trau-matism which have such an obvious bearing in determining the onset of the J 10 II 12 13 II 18 19 20 21 22 23 2<t 25 26. Fig. 131.—Chart Showing the Number of Cases of Acute Osteomyelitis Occurring in DifferentYears of Life. The numbers on the left represent the total percentage of cases affected with the dis-ease, while those at the top of the chart represent the different ages from one to twenty-six years. Aswill be observed, there is a gradual rise, with fluctuations, till the seventeenth year, then a rapidfall occurs; the disease practically disappearing about the twenty-first year, when ossification iscomplete. (From Trendel, in Beitriige zur klin. Chirurgie, 1904, vol. xli., p. 607.) malady that they may be very well considered under the heading of disease, in practice, is found to be confined to a large extent to childrenbelow the age of puberty. It may occur, however, at any period of life beforethe ossification of the epiphyses with the diaphyses of the long bones is com-pleted, but it is almost
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