Tuberculosis of bones and joints / by N. Senn.

  • Nicholas Senn
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculosis of bones and joints / by N. Senn. Source: Wellcome Collection.

    38/578 page 16
    W. Mueller ( Experinien telle Erzeugung dcr typischen Knoclientiiberculosc. Gentndblatt f. Chirurgie, 1886, p. 233) produced experimentally the .typical form of tuberculosi.s in bone by the injection of tubercular material into the nutrient artery of the tibia. Konig has claimed for a long time that the wedge-shaped sequestrum so frequently found in tubercular foci in the articular extremities of the long bones was due to occlusion of a small artery by a tubercular embolus. Mueller proved the correctness of this conclusion derived from clinical observation by experimentation. He made sixteen experiments on rabbits, injecting tubercular pus into the femoral artery, some in a peripheral, some in a central, direction, without any posi- tive results. In a second series the same material was thrown into the nutrient arteries of the femur and tibia. Of ten ol' these cases, two showed a tubercular focus in the medulla of the diaphysis of the tibia; in another case miliary tuberculosis in the femur and tibia, and in the latter bone a small caseous spot in the spongy part, which contained numerous bacilli. The animals were killed eight weeks after the injection, and showed no evidences of organic disease, except a few tubercles in the lungs. Twenty experiments were made on young goats, five on sheep, and two on dogs. The tubercular material was injected directly into the nutrient artery of the tibia, tlie tibial artery being tied above and below the vessel. Primary union of tlie wound Avas obtained in all cases except in one dog. In tlie df)gs and sheep, all experiments yielded negative results. In \\w goats, bone affections were produced which were identical with tubercular bone-lesions found in man. Most frequently the disease was established in the diaphysis, cheesy masses and granulation tissue sliowing themselves in the medulla, the result of tubercular osteomyelitis with or witliout sequestration. Typical lesions were also found in the ends of the bones, witli and without implication of the adjacent joints. In two of these cases the epiphysis was affected, while in three the shaft alone was involved. The following experiment furnishes a good illus-
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