Atrophy of Bone. 207 



absent in the scapula, metacarpals, metatarsals, and phalanges. 

 The lones on the right side are also less in girth than those on 

 the left. 



The changes in the ends of the bones, resulting from the 

 deformities acquired in early life, are met with both on the 

 right and on the left side, though much more pronounced in 

 these of the former or paralysed side. They reach their acme 

 in the lower extremities. The right hip-joint presents a complete 

 dorsal dislocation of the head of the femur, with corresponding 

 changes in the articular surfaces ; at the left side the dislocation 

 is only partial. The right knee-joint is flexed to such a degree 

 that the articular surfaces of the condyles are not in contact with 

 the tibia; the facets of the latter are in contact with the 

 superior aspect of the posterior extremities of either condyle. 

 On the left side the flexion is less pronounced and the leg is 

 rotated outwards. 



The right ankle-joint was acutely^flexed, remarkable — seeing 

 that the toes of paralysed limbs are usually pointed : the 

 superior surface of the neck of the astragalus articulated with 

 the anterior aspect of the shaft of the tibia. On the left side 

 the toes were pointed. 



In the upper extremities there are no evidences in the 

 articular ends of the bones of the large joints of the contracture 

 deformities on the right side, corresponding to those in the 

 lower extremity. The articular surfaces remain in contact 

 with each other, and are covered with hyaline cartilage. The 

 hand, however, on the right side, preserved in its original 

 conditions, presents the usual features of hemiplegic contracture. 



The brain. — See nervous system. 



(For a more minute description of the above skeleton, see the 

 description by Dr Alexis Thomson in Journ. Anat. Phys.) 



G. C. 3496. 

 Preimred and frtsentcd by Alexis Thomson, F.R.C.S.E. 



6. 18. Alterations in Skeleton in a Case of Paralysis 



