Syphilitic Affections of the Skeleton. 315 



is a slight deposit of periosteal bone, just above the front of the 

 lower articular surfaces. The bones of the hand show no 

 definite change. 



The pelvis shows no characteristic change. On both sides 

 the vascular channels seem unusually well marked, and on the 

 right side, the outer surface of the ilium is slightly roughened 

 by periosteal formation. The right femur is thickened from 

 the lower end up to about the middle, but more behind than in 

 front. The surface of the thickening has all the appearance of 

 new periosteal formation, and is more irregular on the back 

 than in front. One vascular channel on the back is enlarged 

 into a distinct aperture. The shaft of the left femur is 

 thickened about the middle, mostly on the inner side, but also' 

 slightly all round. A periosteal crust can be traced downwards 

 to the knee-joint, especially on the inner side. On both tibiae 

 the vascular pores are enlarged, and some new bone has been 

 formed on the shin surface and at the attachment of the tibialis 

 anticus muscle. Both fibulae show slight periosteal rough- 

 ness at the muscular attachments, and an enlargement of 

 vascular pores. The bones of the foot show no appreciable 

 change. G. C. 3391. 



6. 283. Syphilitic Disease of the Clavicle.— A left clavicle- 

 macerated, illustrating the above. 



The greater part of the bone has been afi'ected. About 

 the middle the anterior and upper parts have been attacked,, 

 and an excavation has been formed, in the base of which are 

 fragments of necrotic-looking bone partially separated. This 

 excavation is surrounded by new periosteal bone, which passes 

 round to the under surface, and fades off at either side. The 

 outer end of the bone is irregular and partially absorbed, and 

 near it new periosteal bone has been formed. G. C. 993. 



6. 284. Syphilitic Disease of the Sternum.— Sternum- 

 macerated, illustrating the above. 



