perfectly obliterated, is filled with a denser cancellated structure than elsewhere. The bone is otherwise quite healthy ; and, though the idea of a syphilitic node has been suggested, there can be no reasonable doubt that the bone had been fractured. 1847. Dr. J. G. Warren.
1154. Abrupt and very marked curvature of the shaft of the fibula ; and possibly the result of fracture. 1847.
Dr. J. O. Warren.
1155. Old fracture of the tibia, just below the middle of the bone, and followed by periostitis. Surface rough ; and the lower half much enlarged and porous. On section, the cavity is seen to be obliterated, and the walls of the lower fragment are quite thin. The irregularity at the seat of fracture is slight, and externally hardly perceptible, in con- sequence of the extensive and very thick periosteal deposit, so that the existence of a former fracture would be very questionable, if the fact were not known.
The patient was a healthy man, about forty-five years of age, and had his limb amputated in 1861. Twelve years previously he had a compound fracture of both bones, with extensive laceration of the soft parts, and never worked from that time. An ulcer formed, which never ' healed, and the whole limb became swollen, oedematous, and livid. Health quite good since the operation. 1864.
Mr. J. H. Chandler, med. student.
1156. Compound fracture of both bones of the leg, near the ankle. The end of the tibia is separating, and above the dead line new bone has been thrown out ; the lower frag- ment is quite detached, and is broken through into the joint, but with some appearances of union. The lower fragment of the fibula is quite comminuted, but with some union. From a man, set. sixty. (Hospital, 77, 166.) Am- putation at the end of two months, and the patient did well. 1858. Dr. H. J. Bigelow.
1157. Portion of the tibia, that must have been removed from a case of compound fracture. A large piece of bone at the fractured extremity is dead, and in the process of separa-
�� �
