Acute haematogenous osteitis in childhood.

This paper is concerned with the observations made on 212 cases of acute haematogenous osteitis admitted to one of the surgical units of the Royal Hospital for Sick Children, Glasgow, during the years 1936 to 1950. The term osteitis is preferred to osteomyelitis because the bone marrow plays only a small part in bone suppuration (Nowicki 1931, Romanis and Mitchiner 1932, \Vhite 1937, and Dennison 1948, 1951). In many centres the older terms periostitis, osteitis and osteomyelitis as denoting separate diseases have been abandoned and the inflammations of bone tissue are alluded to as osteitis, a term which covers all the essential structures of a bone. By ‘ ‘ acute “ osteitis we mean a sudden illness with severe toxaemia and definite evidence of inflammation of bone, the duration of the illness being days rather than weeks (\Villiams 1932) . Streptococcal osteitis of infancy, by its nature and age incidence, differs from the disease that we are considering (Dennison 1948) and has therefore been excluded from this review. The treatment of osteitis falls naturally into three periods: 1) The period before the introduction of chemotherapy. 2) The period of effective chemotherapy. 3) The penicillin “ era.” The present survey offers an opportunity of assessing the various therapeutic agents in three comparable groups of patients. Group I covers the five-year period (1936-1940) immediately before the