310 Diseases of Bone. 



6. 272. Syphilitic Disease of the Skull after Separation of 



Sequestrum. — Skull-cap of an old person, probably a woman 

 — macerated, illustrating the above. 



On the frontal bone, to the right of the middle line, and 

 extending downwards from about one and a half inches below the 

 coronal suture, there is a rough irregular depression. It shows 

 a perforation above, and ends in a deep branching groove below. 

 The margins are bevelled off, and in some places the irregularities 

 are rounded as if there the disease had been healing, while at 

 others they are sharp as if it had been extending. The interior 

 of the bone shows marks of increased vascularity, especially on 

 the frontal bone, which is thickened on the right side, and shows 

 irregular depressions on the left. The bone, as a whole, is thin, 

 but the diploe is condensed. G. C. 367. 



6. 273. Syphilitic Disease of the Skull— Healing" after 



Extensive Destruction. — Skull of an adult — macerated, 

 illustrating the above. 



The disease has been most advanced on the frontal bone 

 and on those of the face, round the nose and mouth. On the 

 ovitside there is considerable roughness and porosity near the 

 external occipital protuberance. The diploe, where exposed, 

 seems for the most part normal. The whole of the lower part 

 of the frontal bone is also roughened and irregular. Above, the 

 irregularities are shallow, and the surface is smoothed over, but 

 below they are deeper and the bone surface is porous. At one 

 spot the frontal sinus has been opened into. The margins of 

 the anterior nares have been attacked, and the bone is porous. 

 The alveolar border shows similar changes, and many of the 

 teeth must have fallen out shortly before death. The hard palate 

 is roughened, and on the left side is perforated by a small 

 aperture. The interior of the skull shoAvs marks of increased 

 vascularity, especially in the frontal region, but this is less 

 marked than might have been expected from the condition of 

 the outside. B. C. i. 7. M. 24. 



