MEMOIRS OF THE NATIONAL ACADEMY OF SCIENCES. 171 



In several instances the groove on the atlas for the suboccipital artery and nerve was con- 

 verted into a foramen more or less complete, sometimes on both sides in the same subject. In H. 

 25 there are very complete foramina on both sides. In a number of cases the vertebral foramen 

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

 other. 



Among the vertebra? there were five instances of what might have been congenital union; in 

 two the occipital bone was united with the atlas; in two others the axis was united with the third 

 cervical vertebra, and in one, two adjoining dorsal vertebra} were soldered together. The lines of 

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

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

 tebra, more doubtfully of congenital origin, there was partial destruction of the posterior arch of 

 the axis, apparently due to suppuration. 



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

 incompleteness by the small cavity in the articulation. There were also some cases of fissure of 

 the lower part of the sternum, and the shape of the ossified portion of the ensiform appendix varied 

 as usual. 



One rib was bifurcated anteriorly. 



The tibia? and fibulae on both sides in H. 90 exhibited a marked uniform symmetrical anterior 

 curvature. The index of the right tibia, as shown in Table LXXIV, was 53.03, a very low index, 

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

 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 name of saber bones than any in the series. There was no certain sign of 

 inflammation or degeneration in these bones. The skeleton unfortunately was quite incomplete, 

 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 coudyles 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 Osteophyte bound them together anteriorly. This is the only case which suggested the pos- 

 sibility of rickets, but the symmetry of the curvature disposes one to doubt that 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 vertebra? were absent, one of the dorsal vertebrae, 

 apparently the eleventh, showed the condition somewhat like that seen in cheesy degeneration and 

 cariesof the vertebral bodies. The body of the bone was shaped like a truncated wedge (ride 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 right femur, and 

 the right ulna and both fibula? showed an uneven surface that might 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 with good union and no deformity except a slight over- 

 lapping. 



There was one case of anchylosis of astragalus and os calcis, and another of the second 

 metatarsal and middle cuneiform bones, both probably traumatic. 



Disease. In about one-third of the cases periosteal fringes of new bone were found along the 

 edges of the bodies, and sometimes of the lamina? of the vertebne. In view of the incompleteness 

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

 the disease occurred in the different regions. Apparently it affected most frequently the lumbar 

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



: Principles aud Practi<-c of Surgery, Philadelphia, 1878; Vol. l, p. 



