The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . eople, who are the subjects of this diathesis. They have been for themost part described as the results of the deposit of tubercle in thistissue, but are always connected with chronic inflammatory processesof a low type, the exudations of which undergo caseation, whilst thetrue grey granulations are but rarely found. Tlie characteristic featureof this disease is the production of chronic osteitis and periostitis, cir-cumscribed abscess, caries, and necrosis. Tiiese changes most com-monly take pla
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . eople, who are the subjects of this diathesis. They have been for themost part described as the results of the deposit of tubercle in thistissue, but are always connected with chronic inflammatory processesof a low type, the exudations of which undergo caseation, whilst thetrue grey granulations are but rarely found. Tlie characteristic featureof this disease is the production of chronic osteitis and periostitis, cir-cumscribed abscess, caries, and necrosis. Tiiese changes most com-monly take place in the cancellous tissue, and consequently affect theepiphyses of the long bones more than the shafts, and frequently leadto implication and destruction of the contiguous joints. In the shortbones, as those of the tarsus, thej commonly lead to caries and ne-crosis ; and afiecting, as they often do, the bodies of the vertebrae, veryfrequently give rise to some of the most destructive diseases of thespine, attended hy the formation of large lumbar and iliac abscesses. SCROFULOUS OSTEITIS, 199. Fig. 418.—Scrofulous Vomica in Head ofTibia. Under the influence of this diathesis, a low form of inflammation isreadily established in the osseous tissue, as the result of any slightexposure to external violence or cliange of temperature; and thisrapidly leads to caries, with tlie formation of curdy pus in which massesof softened tissue may be seen. If this destructive action take placewith great rapidit}^, portions of the bone will be found to necrose insmall masses, which lie at the bottom ofthese carious cavities, as ma}commonlybe observed in some forms of strumouscaries of the os calcis and head of thetibia. These scrofulous voraicse under,mine the overlying articular cartilageand thus opening up the interior, give*rise to the most destructive suppurativedisorganisation in it. Fig. 418 is arepresentation of one of these vomicae inthe head of the tibia, tlieir most com-mon seat. Wh
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