Syphilitic Enlargement. 323 



6. 309. Syphilitic Enlarg-ement of the Femur.— Right femur 



— macerated, illustrating the above. 



The bone is heavy, and the surface shows at various places 

 ■diflfused thickenings, with marks of increased vascularity. The 

 neck is short, and the head, owing to absorption, is below 

 the level of the trochanter. The margins of the articular 

 surface are prolonged and overhang the neck — changes often 

 seen in arthritis deformans. Sir Charles Bell notes : " The 

 sinking of the head of the bone and distortion of the neck 

 have been consequent on disease. An appearance is presented 

 in the specimen which has been described by some as a 

 reunited fracture within the capsular ligament." 



Probably syphilis has altered the shaft, and arthritis 

 deformans the upper end. B. C. i. 1. M. 22. a. 



6. 310. Syphilitic Enlarg-ement of the Tibia. Eight tibia 



of an adult, from the same syphilitic subject as that from which 

 !Nos. 6. 306 and 6. 307 were taken — macerated, illustrating the 

 above. 



There is an enlargement on the outer surface, three or four 

 inches from the lower end, and a periosteal crust extends on 

 the shin surface as high as the upper third. An elongated 

 patch of new periosteal bone is seen on the outer surface, 

 at the attachment of the tibialis anticus. The bone is some- 

 what increased in weight. B. C. i. 5. M. 53. 



6.311. Syphilitic Enlargement of the Tibia.— Left tibia, 



from the same subject as the last — macerated, illustrating the 

 above. 



There are periosteal crusts on the shin surface, and also at 

 the upper part of the outer and posterior surfaces. The bone is 

 also somewhat increased in weight. B. C. i. 5. M. 55- 



