In December, 1883, I was called to see a boy, aged 13 years, who had been treated three weeks for rheumatism. On examination, I found the leg much swollen, very hot and painful, with marked fluctuation, the result of extensive periostitis. The boy was very anæmic, and much exhausted.
I opened the leg at its upper third, and anterior aspect, and discharged over a quart of pus and broken down tissue. A rubber band was applied, and a restorative course of treatment was given for four weeks, until the system could be restored sufficiently to permit the removal of the diseased bone. On January 30th, 1884, with the patient under influence of chloroform, I began an incision close to the knee, and finding no sound bone, continued the same to the ankle; and by the use of the enucleator, separated the tibia from its epiphysis.
The upper end having been