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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1888 Excerpt: ...became rilled with a blood-clot, which organized without suppuration. The treatment of the osteomyelitic processes of the femur and their sequela3, notably of necrosis, presents peculiar difficulties of technique mainly due to the deep site of the bone. Long incisions are usually indispensable, access to the remote portions of the bone is difficult, and the necessary injury to many muscular brandies of the femoral artery, and the difficulty of effective compression of the muscular masses, render the question of after-lnvmorrhage rather serious. It is, therefore, advisable not to deplete the limb by an elastic bandage of all its blood before applying Esmarch's constriction. Each cut vessel will then pour out a small quantity of blood, and can be readily seen and deliguted. Tin' safest approach to the bone is from tin external aspect, preferably above, or below the barn-strings. On the inner side, Hunter's canal requires careful attention on account of the femoral artery. The sequestrum is generally located near the posterior aspect of the lower end of the shaft. Should it even occur that the popliteal abscess perforate on the inner aspect of the thigh, exposure of the sequestrum from the external side will be safer and more easy. By the free use of the chisel and mallet, sufficient access can be gained to remove the sequestrum. Even the most expert operator will occasionally fail to find a small sequestrum, or will not succeed in its entire removal. The eventual necessity of a repetition of the operation should be pointed out from the outset to the patient. Inferior Maxilla.--As a rule, ostcomyelitic foci of the lower jaw communicate with the oral cavity. This makes the preservation of the aseptic condition of the wound rather difficult, and sometimes, notab...

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