206 Diseases of Bone. 



hemiplegia occurring in infancy, together with uninterrupted 

 recumbency in bed for nearly thirty years. Those features 

 specially connected with the hemiplegia show themselves, 

 especially in the bones of the right arm and leg, and to a very 

 much less extent in the trunk ; those features resulting from 

 the recumbency and disuse are superadded to the former on 

 the right side, but are also present in those of the left. 



In the trunk there is no apparent asymmetry apart from 

 the scoliosis. Those on the paralysed side do not suffer by 

 comparison with those on the side which retained the power of 

 movement. 



The spinal column exhibits a type of curvature seldom 

 met with, and in all probability only developed under condi- 

 tions present in this case, i.e. paralysis of one side plus recum- 

 bency. That little movement took place during life is 

 evidenced by the bony union of certain of the laminge. The 

 thorax has altered during the preparation of the specimen ; it 

 was scarcely, if at all, involved in the scoliosis ; it was Avell 

 formed, beyond a moderate flattening from before backwards. 



The pelvis, of the female type, is most notably wasted and 

 thinned ; its diameters considerably altered. 



The bones of the extremities are on both sides small, thin, 

 and light, deficient in ridges and marks for muscular attachment, 

 present a fairly developed cortical layer in the shafts of the 

 long bones ; the medulla and spongiosa very small in amount. 

 The articular ends of the long bones and the short bones (e.g. 

 tarsus) have but a thin and imperfect cortex, capable of being 

 indented Avith the finger-nail. The ends of the long bones 

 also present alterations resulting from the deformities to be 

 presently described. 



Those on the right (or paralysed) side not only present the 

 above features in a greater degree, but show evidences of the 

 nerve lesion. They are distinctly shorter. This, as shown by 

 measurement, varies in the different bones. It is most pro- 

 nounced in the following bones, and in the order given : — 

 humerus, femur, fibula, radius, ulna, tibia, clavicle. It is 



