332 Diseases of Bone. 



The lower part of the tibia shows a node-like thicken- 

 ing which extends nearly all round. The thickening rises 

 abruptly from the surrounding bone above. Its surface is 

 rough and porous, as if it had formed the base of an extending 

 ulcer. One or two smaller nodes may be seen above the large 

 one. The bone is unusually light. The grounds for believing 

 this to be a case of syphilis are the presence of the nodes, and 

 of so large an ulcer in so comparatively young a person. 

 (See No. 6. 339.) G. C. 1179. 



Fresented hij Professor James Russell. 



6. 342. Syphilitic Disease of the Tibia, probably com- 

 plicated by Ulcers. — Left tibia of an adult in section — 

 macerated, illustrating the above. 



On the inner or shin surface there is a smooth node-like 

 swelling above the middle, and lower down two abrupt nodes, 

 which may have lain beneath ulcers of the skin. The upper of 

 these two is the smaller and has a porous surface. The other 

 larger one has its surface partly smooth and partly porous. The 

 outer and posterior surfaces of the bone are rough and irregular. 

 The medullary cavity is occupied by cancellous bone beneath 

 the upper node, and at other places shows irregular dilations. 

 These in old syphilitic bones usually contain fat, not pus 

 or caseous matter, as might possibly be supposed. The tissue 

 of the bone is on the whole lightened, and the compact outer 

 layer has for the most part been replaced by cancellous tissue. 



B. C. I. 5. M. 78, 79. 



6. 343. Syphilitic (Mercurial?) Disease of the Tibia, with 



Necrosis. — Right tibia and fibula — macerated, illustrating the 

 above. 



This was formerly described as "tibia and fibula of the right leg 

 of a person affected with syphilis. The disease continued for twelve 

 years, during the greater portion of which time mercury was taken." 



