A treatise on diseases of the bones / By Thomas M. Markoe.
- Thomas M. Markoe
- Date:
- 1872
Licence: Public Domain Mark
Credit: A treatise on diseases of the bones / By Thomas M. Markoe. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![on the inside of the limb hud liealed entirely. lie is entirely free from pain. No interruption occurred in the proj:^ress of his cure, which was complete when he was discharged from the hospital. Cask II.—Edward Smith, aji^cd nineteen, I saw at Bellevue Hospital, by the kindness ot Dr. C. D. Smith, under whose charge the patient was admitted. He had presented himself at the hospital, November 11, 1857, with an enlargement of the lower part of the left tibia, which, he said, had commenced with an acute attack of inflammation of the leg, last July. This attack he attributed to a very prolonged exposure in fishing for oys- ters while the water was yet quite cold. He went to bed ill that night, and the next morning great pain in the lower portion of the leg announced the commencement of a severe intlammation, which soon terminated in suppuration. It was opened in about two weeks, and a large quantity of offensive matter discharged. Several other abscesses formed at intervals, and from them small fragments of dead bone were discharged, the larcrest not bi^jjer than the fin£:er-nail. lie continued to Buffer a great deal of ])ain and discomfort about the limb, and the irritation was so great, and so easily aggravated by han- dling or by exercise, that he was conlined to his bed during most of the time. AVhen admitted, his general condition, though obviously affected by long-continued sutfering, was tolerably good. The lower third of the tibia was much enlarged, and the integuments over it tliickencd and inflamed. Five orifices were situated on the anterior surface, into each of which a probe could be passed deeply into the substance of the bone. Here and there the probe seemed to grate against bare bone, but no distinct sequestrum could be discovered. The lowest orifice was about two fingers' breadth above the ankle-joint, which was not in any way involved in the disejise. The dis- charge was not large, but was somewhat offensive. The case was pronounced to be one of sinuous al)scess, without necrosis, and the operation was j^erformed by Dr. Smith on the 28th of Novrmlu'r. By the trophine and chisel, the sinuses were care- fully followed through the bone, and their anterior wall ro- movi'd, thn- laying them freely open to the bottom. They were all found to communicate with one another, and at the](https://iiif.wellcomecollection.org/image/b21014413_0052.jp2/full/800%2C/0/default.jpg)
