Hematogenous osteomyelitis is considered a surgical problem. It is our belief that antecedent to the presenting surgical problem of acute osteomyelitis is the fact that susceptibility to this infectious process depends on the presence or the absence of immunologic defenses in the host. These defenses are the preeminent factors in susceptibility, acuteness and chronicity, and they may determine the mortality and the tendency to recurrence.
In the hands of experienced surgeons operative technic has reached a supreme degree of perfection. No one questions that surgical intervention for osteomyelitis is frequently a life-saving procedure and markedly shortens the course of the chronic infection. In the face of these facts the incidence of osteomyelitis remains the same, and the percentage of recurrences in properly handled cases still remains high. This evidence warrants a study of the immunology of this infectious process in an attempt to throw some light on the problem of