. The diseases of children : medical and surgical. e of sponge, which remained in place tillMarch 6, when some of it was cut away ; several bleeding points in it then appeared, dueto granulations which had sprouted into it and held it firmly in position ; at this time theleft base was normal, except slight dulness. On March 13 antiseptics were discontinued ; on the 20th more of the sponge was cut away, andat the end of the month the rest was removed ;it was found that it was impeding healing andcausing eversion of the edges ; the sponge wasfilled with granulation tissue, which microscopicallyw
. The diseases of children : medical and surgical. e of sponge, which remained in place tillMarch 6, when some of it was cut away ; several bleeding points in it then appeared, dueto granulations which had sprouted into it and held it firmly in position ; at this time theleft base was normal, except slight dulness. On March 13 antiseptics were discontinued ; on the 20th more of the sponge was cut away, andat the end of the month the rest was removed ;it was found that it was impeding healing andcausing eversion of the edges ; the sponge wasfilled with granulation tissue, which microscopicallywas seen to penetrate the unaltered sponge frame-work. The wound rapidly closed, and on May 5he was discharged almost well; there was littleif any retraction of the side, and the lung hadapparently fully expanded. Here traumatic peri-ostitis of the rib led to abscess externally andserous effusion into the pleural cavity ; after theopening was made probably the suppuration inthe chest cavity resulted from the communicationwith the external It is usually only in cases which are sosevere as to be fatal that joint invasion ormultiple bone lesions are found, but wehave met with an instance in which the tibiawas first attacked, then the knee joint bydirect extension, the humerus, lower jaw andopposite femur all were involved, and yetthe child completely recovered. Arrest of growth from destruction orsynostosis of the epiphysial line may result^ ;or, on the other hand, there may be over-growth from persistent hypersemia of thelimb, as the result of the subsequent irri-tation caused by sequestra (fig. 139). Thisovergrowth may, as seen in the figure, cause distortion from one bone of thelimb outgrowing the other.^ Occasionally relapses occur many years afterthe original disease has subsided, and abscesses form, and sequestra are 1 J. H. Morgan has detailed a case in the Brit. Med. Jour., September i, 1883. Thehumerus was the bone affected. Vide also Tubby, Lancet, June 6, 1891.
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