PERSONAL APPEARANCES IN HEALTH AND DISEASE. 37 



alterations in organs contained within or in contact with 

 the bony structures, and others, again, to altered con- 

 ditions of the bones themselves, arising primarily, and 

 independently of any previous condition of contiguous 

 parts. When a bone is broken there may or may not be 

 considerable deformity ; its occurrence depending on the 

 nature arid extent to which the injury has taken place, 

 the position of the bone itself and its connection with 

 muscles. In consequence of this, sometimes most 

 careful scrutiny will fail to detect that a bone is broken, 

 whilst at other times the whole limb may be bent and 

 the injury be manifest at once. Thus a rib may be 

 broken, but no external change in shape will reveal the 

 fact to the observer. But the arm or thigh may be frac- 

 tured, and the amount of deformity be striking. The 

 more oblique the fracture is, the greater the resulting 

 deformity j for then the muscles attached to the fragments 

 will in their traction on each pull them the one over the 

 other and so lead to shortening of the limb. 



Sometimes when the two fragments of a broken bone 

 do not grow together again naturally, or unite in a dis- 

 torted manner, the limb remains permanently misshapen. 

 But even where the union is natural and perfect, an 

 irregularity in the shape of the bone itself will denote 

 long after the spot where the junction has taken place. 



The main cause of distortions in the shape of the bony 



