The sequestra were examined at the laboratory associated with the Deaconess' Hospital in Boston and a report of "tuberculosis" was made. This came as a surprise in view of the findings at operation and there was a question as to whether the graft would survive.
It was impossible to state definitely at what time this tuberculosis appeared in the symphysis. There is no doubt but that the long continued fever was due to tuberculosis, but whether of the spine or pubis or both it is impossible to say.
There is no doubt but that this lesion had been present for a great many years. A noteworthy fact is that at no time did she have any definite symptoms in this region but her symptoms were entirely mechanical,—viz., due to lack of fixation in front, a strain had been put on both sacro-iliac joints and it was this strain that had bothered her—nothing else.
A surprising feature of this case is that after the destructive process was noted in the symphysis, the original x-rays were examined and the same process found. This had completely escaped the roentgenologist, and at the first operation through the abdomen palpation of this region was entirely normal.