The Calcutta Medical Society

hospital with an acutely bent knee-joint. An abscess was detected on the outside of it which was opened. The operation was followed by sloughing cellulitis which spread up and down the limb, extending upwards beneath the quadriceps extensor and downwards between the gastrocnemius and soleus. The back of the head of the fibula was found tr> be bare, and subsequently the front of the shaft of the tibia. Free counter-openings were made. The constitutional symptoms were very severe, consisting of high fever of a hectic type. Fluid was detected in the knee-joint, which was found' on exploration by means of a capillary trocar to be purulent. Amputation was resorted to to save life which was rapidly ebbing under the continual pyrexia and exhausting discharge. This measure promptly produced a change for the better, and the patient is now almost well. The knee-joint was found full of pus; its cartilages extensively eroded, and cavities existed in the tuberosities of the tibia, and condyles of the femur containing nodules of dead cancellous bone. These cavities communicated with the joint cavity, and were lined by a kind of pyogenic membrane. This condition was one of necrosis rather than of caries : in-