MH.MOIKS OF Tllli NATIONAL ACADK.MY OF S(:iFN(.'i:S. 171 



In several instances the groove on the atlas lor the snboccipital artery and nerve was con 

 verted into a lorauuMi more or less coniitlete, sometimes on both sides in the sanui snbjeet. In II. 

 -'"> there are very complete loramina on both sides. In a number of cases the vertt^bra! foramen 

 was subdivided into two openings, and sometimes it was much smaller on one side than on the 

 other. 



Among the veitebra' there were five instances of what might have been cong(!nital union; in 

 two the occipital bono was united with the atlas; in two others the axis was united with th(! third 

 cervical vertebra, ami in one, two adjoining dorsal vertebral were siddered together. The linesof 

 union in these cases were even and smooth and there were no exostotic growths mljacent to sug- 

 gest the existence of intiamaiation. In one other case of union of the axis and third cervical ver- 

 tebra, more doubtfully of congenital <uigin, there was partial destruction of the jiosterior arch of 

 the axis, api)arcntly due to suppuration. 



There were four cases of union of the (irst and second pieces of the sternum, showing the usual 

 incomi)lcteness by the small cavity in the articulation. There were also s(m»c cases of fissure of 

 the lower part of the sternum, and the shape of the ossified portion of the eiisiform ai)pendix varied 

 as usual. 



One rib was liifun-ated anteriorly. 



The tibia- and fibuhe <ui botji sides in 11. !)(» exhibited a marked uniform symmetrical anterior 

 curvature. The index ot the right tibia, as shown in Table LXXIV, was .■».'5.0'{, a very low index, 

 yet exceeded in this respect by several of the series. The index of the left tibia was not (-om- 

 puted, as the bone was so split that it was feared the normal dimensions could not be obtained. 

 These were the only leg bones that showed this curvature to any noteworthy degree. They were 

 better entitled to the uame of saber bones than any in the series. There was no certain sign of 

 intlammation or degeneration in these bones. The skeleton unfortunately was quite im-omplete, 

 but what remained showed the following lesions: A healed fracture of the outer third of the right 

 clavicle; small exostoses on the articular surfaces of the condyles of the lower jaw; bony growths 

 on the sites of many tendinous insertions; a few of the vertebral bodies were very friable and a 

 large osteojihyte bound them together anteriorly. This is the only case wliich suggested the pos- 

 sibility of rickets, but the syn\metry of the curvature disposes one to doubt tliat this disease 

 existed. 



Still it is possible that the case comes under the class described by Agnew* as " mild form of 

 rickets.*' 



Injuries. — There were some specimens showing the healing of fractures, three of the clavicle 

 and one of the tibia; the latter had healed with marked deformity. Recent fractures could not of 

 course be recognized because of the general fragmentary character of the bones. 



In one case, where unfortunately most of the vert«'bra' were absent, one of the dorsal vertebra;, 

 apparently the eleventh, showed the condition somewhat li!;e that seen in cheesy degeneration and 

 cariesof the vertebral bodies. The body of thebone was shai)ed likea truncated we<lgc ( riiJe infra). 

 In the same case three ribs, apparently the sixth, seventh, and eighth, right side, showed poste- 

 riorly from the head to the angle a rough surface with exostotic growths, as if the ribs had formed 

 the wall of an abscess. There was also an impacted fracture of the neck of the light fenuir, and 

 the right ulna and both fibuhe showed an uneven surface that miglit possibly have resulted from 

 a contusion with consequent inflammation. Altogether I regard the condition as one general injury, 

 probably from a fall on the right side. 



There was one case of fracture of rib witli good union and no delonnity except a slight over- 

 lapping. 



There was one case of anchylosis of astragalus and o« cahis, and another of the second 

 metatarsal and middle cuneiform bones, both probably traumatic. 



DixeoHc. — In about one-third of the ca.ses periosteal fringes of new bone were found along the 

 edges of the bodie.s, and sometimes of the lamina' of the vertt!brii>. In view of the incompleteness 

 of the individiml sets, it is impossible to state with any accuracy the relative frequency with which 

 the disea.se occurred in the different regions. Apparently it aft'ected most frequently the lumbar 

 region, next the dorsal, then the cervical, and least of all the sacral. In two cases only there 



•Ao.NEW: I'riiiriple.s aud I'ractirc iil' Surgory, I'liilailelphiu, 1S7S; \ol. 1, ]>. 1032. 



