Syphilitic Enlargement. 329 



There is a periosteal node near the loAver end, which is 

 porous and eroded on its outer surface. B. C. i. 5. 'M. 85. 



6. 332. Syphilitic (?) Enlargement of the Fibula.— Lower 



end o± a left fibula — macerated. 



There is much new periosteal formation upon its inner 

 surface, with rarefaction at one place. B. C. i. 5. M. 84. 



6. 333. Syphilitic (?) Enlarg-ement of the Fibula.— Left fibula 



— macerated. 



There is much irregular periosteal formation on its anterior 

 and outer surfaces, near the middle third. W. C. G. 16. 



6. 334.' Syphilitic (?) Enlapgement of the Fibula.— Left fibula 



— macerated, showing great irregularity and enlargement at the 

 malleolus. 



This may have been possibly from syphilis, possibly from 

 tubercular and septic disease of the ankle. B. C. ii. M. 42. 



6. 335. Congenital (?) Syphilitic Enlargement of the Tibia. 



— Section of a right tibia, injected Avith carmine and in spirit. 



"J. E., £et. 22, was admitted to the Eoyal lufirmary under 

 Dr P. H. MacLaren's care, suffering from necrosis of the bones of the 

 forearm, diagnosed to be syphilitic in character. For this condition the 

 forearm was amputated through the upper third on 19th April 1887. The 

 wound healed well. Shortly afterwards at the upper part of the tibia a 

 gumma formed, which softened and burst, leaving an ulcer with bare bone 

 at its base. Another similar ulcer soon formed at the lower end of the 

 tibia. For these the patient was again admitted to the Royal Infirmary 

 in June 1887. Both ulcers continued discharging, in spite of treatment, 

 and without any indication of the separation of the necrosis. As the 

 continued discharge was weakening the patient, the leg was amputated 

 through the lower third of the thigh by Dr MacLaren on 8th November 



