tooth was extracted for toothache of a few days' duration, but without relief. Enlargement of the jaw soon com- menced, increased from that time, and, on admission, ex- tended from the right coronoid process to much beyond the median line upon the left side ; but with no pain after the first three or four months. The bone was removed at once by Dr. B. from the articulation upon the right side to the first molar tooth upon the left, and in about five weeks the patient was discharged well. This year (1867) she has been heard from, and there has been no return of disease. The bone is regularly enlarged, excepting the coronoid process and the articular portion ; structure compact, but rather coarse ; surface rather rough, but nowhere carious. A wedge of bone was sawed out at the time of the opera- tion, in order to ascertain the character of the disease. 1867. Dr. H. J. Bigelow.
1197. Daguerreotype of the above patient before the operation. 1867. Dr. H. J. Bigelow.
1198. The left humerus and the greater part of the right femur, showing a separation of the epiphyses, etc. ; the result of acute inflammation of five weeks' duration.
The patient was a delicate lad, eleven years of age, and on the 15th of August, 1834, the disease commenced. On the 18th, there were active constitutional symptoms, with pain in the right thigh and some in the joints. On the 20th, he was seen by Dr. James Jackson, and of his detailed report of the case the present history is an abstract. There were then the indications of periostitis about the femur ; swelling with some hardness, heat, and extreme tenderness. On the 31st, Dr. J. found him greatly reduced ; thigh about the same, and a similar affection of the right arm, with some extension to the forearm. On the 5th of Sept., the arm was better and the thigh less swollen, but with signs of deep-seated suppuration below the trochan- ter. On the 8th, suppuration about left shoulder-joint, with a projection as from dislocation forward of the bone ; swelling of thigh greatly diminished, as from an absorption of the pus ; pain urgent ; greatly reduced ; punctured left shoulder, and discharged two ounces of health} 7 pus ; the
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