The Hahnemannian monthly . , in anticipation of this, provides an envelope of new Fig. 2. ?*^T ir^~ R JP* • ?*-•*. >- * - * ? s? - ^JWI a p* ~~:- Mi #V#J WUJj^BS^^jj&*- la** VV --Ml 1 ; B Jni Osteomyelitis.—Boston University.—Pathological Museum. Enormous involucrum incident to osteomyelitis of upper end of ulna. Note the large buttresses of new bone. bone—the involucrum—which perpetuates the form and out-line of the limb, and finally, if the patients life continue, andthe limb be saved, takes the place wholly or in part of the de-stroyed shaft. The Sequestrum.—The portion of t
The Hahnemannian monthly . , in anticipation of this, provides an envelope of new Fig. 2. ?*^T ir^~ R JP* • ?*-•*. >- * - * ? s? - ^JWI a p* ~~:- Mi #V#J WUJj^BS^^jj&*- la** VV --Ml 1 ; B Jni Osteomyelitis.—Boston University.—Pathological Museum. Enormous involucrum incident to osteomyelitis of upper end of ulna. Note the large buttresses of new bone. bone—the involucrum—which perpetuates the form and out-line of the limb, and finally, if the patients life continue, andthe limb be saved, takes the place wholly or in part of the de-stroyed shaft. The Sequestrum.—The portion of the shaft which has been 488 The Hahntmannian Monthly. [August, destroyed is thus surrounded by the involucrum. In otherwords, it is sequestered. It remains thus a longtime buried—a dense mass of bone, disintegrating, but slowly—a foreignbody, a focus for microbic germination and suppuration. Bitby bit it finally crumbles and finds its way out through thesinuses which nature has provided. Fig. Osteomyelitis.—Surgical History of the War of the Rebellion. Shows enormous involucra of radius and ulna. Large sequestrum of radius shows through cloaca. The Cloaca.—The involucrum never forms an impermeableenvelope about the sequestrum. One or more apertures aremaintained—conduits for the exit of pus and cast-off spiculreof the sequestrum. These cloacae are always inadequate, easilyobstructed, and provide but poorly for the overflow. 1899.] Osteomyelitis. 489 Spontaneous Fracture.—It sometimes occurs that the destruc-tive progress of the disease is very rapid and the formation ofthe involucrum is slow. As a result of voluntary movementsof the limh in bed, fracture of the weakened bone may is my belief, though, that this is very rare; for the patientguards the tender, painful limb most carefully. Clinical Picture—Symptoms.—The train of symptoms of anordinary, acute, spontaneous osteomyelitis are so clear and un-mistakable that there should rarely
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