Syphilitic Necrosis. 807 



inches across. This piece is surrounded by a distinct trench, 

 which below has penetrated through the skull. The sides and 

 back of the calvarium are comparatively unchanged, but the 

 bone is increased in thickness and the diploe is partially filled 

 \\Y>. The vomer, nasal, lachrymal, inferior turbinated, and greater 

 part of the ethmoid and nasal portion of superior maxillary bones 

 have entirely disappeared. The ethmoidal sinuses and the 

 antrum of Highmore on each side are completely exposed 

 from the nose. The back of the palate is gone, and only 

 a trace of the nasal septum is seen at the roof. Marks of 

 increased vascularity are seen on the malar bones below each 

 orbit. The back of the skull shows at various places patches 

 of roughness owing to increased vascularity. 



B. C. I. 7. M. 18. 



6. 264. Syphilitic Disease of the Skull after Separation 



of a Sequestrum. — Portion of right frontal and parietal 

 bones — macerated, illustrating the above. 



In front there is an aperture with rounded margins, as if 

 necrosis had separated and the part healed. Behind that, and 

 separated from it by a bridge of bone, is another aperture, more 

 irregular and with sharper margins, as if a sequestrum had 

 only recently separated from it. On the inside there are 

 marks of increased vascularity, old-standing in front and 

 recent behind. K^ear the apertures the bone is irregular and 

 eroded in both aspects, but this surrounding irregularity does 

 not correspond on the two aspects. "\Y. C. G. 46. 



6. 265. Syphilitic Disease of the Skull after Separation 



of a Sequestrum. — Portion of the left half of a calvarium — 

 macerated, illustrating the above. 



There is an irregular aperture in the parietal bone, about 

 three inches in diameter each way. The margins of this 

 apertiire are sharp, and a large sequestrum must have only 

 recently separated from it. On the outer surface of the 



