330 Diseases of Bone. 



1887. Although no history of syphilis, congenital or acquired, could be 

 obtained, the syphilitic nature of the disease was diagnosed from the 

 course of the symptoms, and it was considered to be probably congenital." 

 The whole of the bone is enlarged by the formation of 

 cancellated tissue. At the upper end there is a section of the 

 necrosis, and its white, non-vascular character is brought out in 

 contrast with the surrounding injected bone. Round the 

 surface of the necrosis there was an ulcer of the skin, part of 

 which has been left. Part, however, has been removed, to show 

 patches of caseous material, which had been present in the 

 periosteum outside the base of the ulcer. A certain amount of 

 separation of the necrosis had occurred, but not enough to 

 loosen it. Several white caseous deposits are seen in the 

 interior of the bone, above the necrosis, and one or two are 

 seen near the anterior surface at the lower end. On the soft 

 parts, near the lower end, a large gumma is shown, caseous and 

 non-vascular, and surrounded by an area of increased vascularity. 

 In front of this a small sinus in the skin has been left, and 

 the soft parts removed near it, to show that it led down to a 

 gummatous deposit in the periosteum. G. C. 2770. 



Presented by P. H. MacLaren, F.R.C.S.E. 



6. 336. Syphilitic Enlarg"ement of the Tibia.— Upper end of 



a right tibia — macerated. 



There is a deposit of periosteal new bone on the surface.. 

 The bone is increased in weight. F. P. C. 446. 



6. 337. Congfenital Syphilitic Nodes on the Lower Ends 

 of the Tibia and Fibula. — Plaster cast of the left leg and 

 foot of the boy from whom the cast 'No. 6. 295 was taken. 



The cast shows a swelling due to enlargement of the lower 

 ends of the tibia and fibula, just above the ankle. 



G. C. 3283. 



