osteomyelitis

Bee

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Asst. Regtl. Quartermaster Gettysburg 2017
Joined
Dec 21, 2015
osteomyelitis: is infection and inflammation of the bone and bone marrow.[1] It can be usefully subclassified on the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and anatomic location of the infection. Osteomyelitis usually begins as an acute infection, but it may evolve into a chronic condition.[2] The word is from Greek words ὀστέον osteon, meaning bone, μυελό- myelo- meaning marrow, and -ῖτις -itis meaning inflammation. source
 
Yes. I was reading about Trimble and found out that after he was wounded, one of the secondary afflictions to his wounding was this bone infection, osteomyelitis.

Although Trimble avoided the amputation of his wounded leg, his rehabilitation proceeded slowly. For months after, doctors periodically found bone fragments that had to be extracted. By November, he developed camp erysipelas and a probable case of osteomyelitis source
 
I was just working on a long post and getting ready to hit send, Bee. LOL! So here it is, by pure coincidence showing up seconds after your reply.

I'm curious--I could look it up but I'm lazy--how painful a condition was this? It sounds quite painful. What was used to treat the pain other than the usual morphine? Okay, I got a little less lazy. From

Remarks on the Pathological Anatomy of Osteomyelitis, with Cases. By H. Allen, M. D., Asst. Surgeon U. S. A.

"Military surgeons have doubtless observed, during the present war, the liability of gunshot injuries of bone, to be followed by severe symptoms. In addition to secondary hemorrhage and gangrene, which are so apt to attack any wounds in those labouring under a scorbutic taint and malarial influences, injuries to a bone expose to the dangers of osteomyelitis—to pyarthrosis when the fractured or resected region is in the neighbourhood of an important joint—and to many risks of death from prolonged suppuration and pyemia."

He doesn't talk about pain much in the article, so maybe I'm wrong and this isn't a particularly painful condition. The whole article is quite detailed, for anyone interested in this, from January 1865.

Here's another shorter article from 1865, an accident to a teenager in Boston, not a soldier, but could have happened to anyone. There was an amputation, and the boy eventually died. "Subcutaneous injections of morphine were the essential treatment [for pain]." His stump was healed well by the time he died. Apparently osteomyelitis was "a pathological condition of comparative recent investigation," and the author recommends (by pure coincidence I ran into this!) the article I quoted above by military doctor H. Allen! I wonder how old a condition it was, considering all those bone injuries in, well, every war. How odd--it must have been seen and classified as something else, in the days before an understanding of particular microbes causing particular infections.

Long-term antibiotic therapy is recommended today of course, according to Wikipedia, but this is interesting, from Wikipedia's standard main heading for osteomyopathy (don't want a big long scrolling box of text to appear so I'll just describe the link like that):
"Prior to the widespread availability and use of antibiotics, blow fly larvae were sometimes deliberately introduced to the wounds to feed on the infected material, effectively scouring them clean. In 1875, American artist Thomas Eakins depicted a surgical procedure for osteomyelitis at Jefferson Medical College, in a famous oil painting titled The Gross Clinic."

First, blow-fly larvae? Really? Why only for osteomyelitis and not other things with infected tissue, or were they used for other things, or was it because the treatment needed to continue so long? Here's one of their footnotes from the 1930s--the other is from more modern date and might not be available: http://m.jbjs.org/content/13/3/438.abstract I've only read the abstract, but it just looks like the obvious stuff you'd want to do to a wound. I wonder if the full pdf explains how you sterilize the blowflies--make them wash their little tiny feet with good soap, and wear little rubber booties, maybe? Or more seriously, maybe keep them in a sterile area for a few days feeding only sterile food?

Secondly, I didn't know that famous painting of the Gross Clinic was a scene showing treatment for osteomyelitis. (Can't everyone who's studied the history of medicine picture it right now, even though it's a little later than the Civil War by just 10 years maybe? Or have I given away my nerd status? Oops.) :nerd:
It's so strange I studied this kind of stuff 15-20 years ago as a mere Civil War-era curiosity, and now I'm interested in it for real. Yep, subcutaneous injections of morphine, they tried that, problem was that it couldn't be done by a home nurse and nobody wants to spend life in the hospital... I don't have osteomyelitis but the pain treatments might be the same--I'm always curious what's out there.
 
I was just working on a long post and getting ready to hit send, Bee. LOL! So here it is, by pure coincidence showing up seconds after your reply.

At this ridiculous hour, who'd of thunk it :smile:

The further reading that I did on the affliction remarks that it can become a chronic condition. I started to relate it to the deep sort of pain that one gets when riddled with arthritis ( which reminds me of the "stooped and irascible Early") I looked up the companion disease that Trimble also contracted erysipelas and it did not seem much more bearable!!
 
Wasn't erysipelas, hives, meaning his system decided it disliked something inside it intensely- could have been infection, Seems such a shame they didn't know a sulpha drug could have helped. The hives, not the infection. Was there anything for infection?
 
Wasn't erysipelas, hives, meaning his system decided it disliked something inside it intensely- could have been infection, Seems such a shame they didn't know a sulpha drug could have helped. The hives, not the infection. Was there anything for infection?

Erysipelas is caused by variety of strep, so today it would have been remedied by antibiotics. In the bad old days, most likely they used a salve.
 
Erysipelas is caused by variety of strep, so today it would have been remedied by antibiotics. In the bad old days, most likely they used a salve.


Ah! So much for my ridiculous impression, had it in my head it was a form of hives and ( yes, I really, really thought this ) swine were prone to it!
 
Ah! So much for my ridiculous impression, had it in my head it was a form of hives and ( yes, I really, really thought this ) swine were prone to it!

Trust me, there are plenty of lookalike reactions that are almost identical in appearance. Severe dairy allergies in children can look just like a lesser case of erysipelas on the face.
 
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