192 



PELVIS. 



even before incineration, left, after exposure 

 to a red heat for some time, a very porous 

 and light inorganic structure. The following 

 results were obtained by thus burning off the 

 organic components 100 grains of bone, 



From the body of an upper lumbar verte- 

 bra left of earthy matter - -31 

 the last lumbar vertebra - - 27 

 lower end of the sacrum - - 24 

 ilium (cotylo-sacral rib) - - 40 

 ischium (near tuberosity) - - 36 

 pubes (near acetabulum) - - 33 

 head of the femur - - -22 

 neck of the femur - - - 25 

 shaft of the femur (below trochant) 58 

 When we compare the foregoing propor- 

 tions of the two constituents of bone with 

 those given by Schreger, as the normal pro- 

 portions of adult bone viz., 20'18 animal, 

 and 74'84 earthy matter the diminution of the 

 inorganic constituents appears very striking, 

 and still greater when compared with those of 

 aged bone ; although less so than in the re- 

 sults of the analysis of Dr. Leeson, in the 

 extreme case recorded by Mr. Solly before 

 given. 



The femurs were perfectly normal in shape, 

 as also were the bones of the lower leg, but 

 the pelvis was a rostrated one, the superior 

 pubic rami being bent in the middle nearly at 

 right angles, and much deformed and con- 

 tracted in all its diameters. It was remark- 

 able, that, at the bend of the superior pubic 

 rami, and at the suture of the ischio-pubic 

 rami, there was a complete deficiency of 

 osseous matter, so that after maceration, the 

 pubes separated at these points ; showing that 

 the connection and continuation of the bone 

 in these places was purely ligamentous, or 

 by organic matter, as if resulting from an un- 

 united fracture. 



The sudden diminution of the hard con- 

 stituents in the head and neck of the femur, 

 as compared with its shaft, is worthy of ob- 

 servation 'in reference to the bending and 

 fracture of the femoral neck in old people. 



The smaller proportion of earthy matter in 

 the pubes, as compared with the ilium, and 

 in the sacrum and lumbar vertebrae, as com- 

 pared with the femoral shaft and pelvis, will 

 account for the greater yielding and deformity 

 which are observed in these parts in the 

 angular pelvic distortion, especially in the 

 rostrated variety, and will be referred to pre- 

 sently in the consideration of the mechanism 

 of pelvic deformities. 



In the analysis made by Dr. Bostock of 

 the dorsal vertebrae of a woman affected 

 by mollities, he found, that the proportion 

 of the earthy constituents amounted to only 

 one-fifth of the whole weight in one part of 

 the bone, and to one-eighth only in another ; 

 while in a healthy bone from the same part, 

 they amounted to more than one half the 

 whole weight.* 



In the analysis given, in Rokitan sky's 



* Med. Chir. Trans, vol. iv. 



work before cited, of a portion of bone af- 

 fected with this disease we find in 100 parts : 

 Phosphate of lime and magnesia - 17 48 

 Carbonate of lime and soluble salts 6'32 



Total of inorganic matter 23*80 

 Cartilage vessels and fat - 76'20 

 Specific gravity of the bone 0'721. 



Among the reasons adduced in favour of the 

 supposition that this disease is sometimes a 

 malignant one, besides the general and violent 

 pains that usually precede the deformity, its 

 incurability and unchecked course towards 

 a fatal termination, have been given. That 

 this result is not invariably the case, the fol- 

 lowing case quoted from Naegele will show, 

 in the fact that the pelvic bones had regained 

 their normal hardness. In the pelvis whence 

 the foregoing analysis was taken, the bones 

 had, most probably, at some former period 

 been much softer than they were at the time 

 of death. Such cases also show, that though 

 very frequently, the pelvic bones distorted by 

 mollities are so soft and pliable as to yield, 

 sometimes considerably, to the foetal head ; 

 yet that this is by no means always the case, 

 nor should it be taken, as it is by some ob- 

 stetricians, as a characteristic mark of this 

 disease affecting the pelvis. 



A very minutely detailed case of pelvic dis- 

 tortion, resulting clearly from one or other 

 kind of mollities ossium, is given by Naegele.* 

 The subject of the case, after having borne 

 six children (five healthy, full sized, and living, 

 and the sixth still born), became affected with 

 this disease, which brought about such exten- 

 sive pelvic distortion and contraction, that, 

 at the seventh labour, the Caesarian operation 

 was rendered necessary, from the conse- 

 quences of which the patient died after the 

 fourth day. The shortness of the time in 

 which the pelvis became so much distorted, 

 together with the extent of the deformity, 

 and the fact that, at the time of the patient's 

 decease, it had regained its normal hardness, 

 render the case a very remarkable one. 

 Naegele considered it as the most contracted 

 pelvis that had ever come under his observa- 

 tion. 



The anterior wall was pushed upwards and 

 the "posterior downwards, the superior plane 

 being bent at the acetabula, so that the 

 upper border of the pubic symphysis was 

 level with the upper surface of the 4th lumbar 

 vertebra ; and a line drawn from one anterior 

 superior iliac spine to the other, cut the 

 upper surface of the 3rd lumbar vertebra at 

 its posterior half. The innominate bones were 

 pushed together, and presented the acute fur- 

 row, like cracked pasteboard, on their inner 

 surfaces. The sacrum was bent almost 

 double. The measurements are given by the 

 author, as follow -j-: 



* Erfahrutigen und Abhandlungen ; and Appen- 

 dix to Das Schrag Verengte Becken. 



f The measurements used by Naegele, (Rhineland 

 or Prussian,) are very slightly larger than the 

 corresponding English ones. 



