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As Max Schueller has shown, there is a characteristic opposition in the manner in which the bacteria of suppuration and of tuberculosis localize and invade the tissue of a long bone. Preferably pus microbes find a footing in the medullary substance of the bone, contrasting with the so often seen tubercular epiphyseal foci. Anatomically suppuration extends throughout the shaft, as a suppurative medullitis, only at times is a bone abscess observed. Tuberculosis, in the great majority of cases, remains fixed at one or more points, forming foci of tubercular osteitis. Only in the small long bones, as in spina ventosa, does tuberculosis extend throughout the bone. The beautiful experiments of W. Mueller, although presented some time ago (1887), that were performed upon sheep and goats with a view of showing the results of injecting tubercular detritus into the nutrient arteries of the long bones, prove, beyond doubt, that here a
TUBERCULAR OSTEOMYELITIS OF THE FEMUR. JAMA. 1892;XIX(20):591–592. doi:10.1001/jama.1892.02420200027006
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