GENERAL DISEASES OF THE BONES. 303 



and abuse, yet its true primary cause is unknown. It is mainly 

 or altogether a disease of early life, under seven years old. 



Treatment should be directed to the improvement of the 

 general health by tonics (cinchona, nux vomica, cascarilla, 

 boneset, willow bark, myrrh, oxide of iron, phosphate of iron, 

 etc.), carminatives (ginger, pimento, fennel, foenugrec, carda- 

 moms, coriander), pepsin, sound nutritious food (given soft- 

 boiled or steamed if necessary), pure air, exercise in sunshine, 

 grooming, etc.) No good can be expected of advanced cases, 

 but only of those seen in the early stage, with some stiffness, 

 and swelling of bone, and the passage of phosphates, to excess, 

 in txie urine. 



FRACTURES. 



These are simple when a bone is broken across ; cotnminuted 

 when broken into several pieces ; and compound when the soft 

 parts are torn so as to establish a communication between the 

 broken ends and the external air. The two last are extremely 

 dangerous, but the first is more hopeful. Simple fractures, 

 however, vary in gravity according to their kind. Thus in the 

 very young the break is liable to be imperfect, with a number 

 of pointed processes locking into each other {greenstick fracture), 

 and as the ends are easily and accurately replaced, and the 

 bones soft and vascular, repair is prompt and perfect. In 

 others the break is directly and smoothly across, or with 

 indentations and processes, so that when the ends are placed 

 in apposition they cannot slide past each other; these, too, are 

 easily repaired. A third class are broken obliquely or with a 

 bevel, so that the broken surfaces slide upon each other under 

 the contractions of the muscles, and the sharp ends are con- 

 tinually jerked into the soft parts around. The continuous 

 movement prevents union, and the irritation of the soit parts 

 sets up inflammation so that such fractures may prove as 

 troublesome as the compowid. 



Symptoms. — Disuse of the affected bone, distortion of the 



