BONE, PATHOLOGICAL CONDITIONS OF. 



443 



impede the expansion of the lungs : her spine 

 was much distorted, and any motion of the 

 vertebrae of the loins excited extreme pain : 

 her legs and thighs being quite useless, she 

 was confined to her bed in a sitting posture : 

 the bones she rested upon, having lost their 

 solidity, were much spread, and the ends of 

 her fingers and thumbs, by frequent efforts to 

 raise herself, were become very broad, with a 

 curvature of their phalanges : she now mea- 

 sured but four feet, though before this disease 

 she was five feet and a half high and well 

 shaped." After death she was found wanting 

 in her natural stature two feet and two inches. 



" All her bones except her teeth were more 

 or less affected, and scarcely any would resist 

 the knife : those of the head, thorax, spine, 

 and pelvis were nearly of the same degree of 

 softness; those of the lower extremities were 

 much more dissolved than those of the upper 

 or of any other part ; they were changed into 

 a kind of parenchymatous substance like soft 

 dark-coloured liver without the least offensive 

 smell. I cut through the whole length without 

 turning the edge of the knife, and found less 

 resistance than firm muscular flesh would have 

 made, meeting only here and there with bony 

 laminae, thin as an egg-shell. 



" Those bones were most dissolved which 

 in their natural state are most compact, and 

 contain most marrow in their cavities. This 

 circumstance may appear more worthy of ob- 

 servation as it held throughout, and looks 

 as if the wonderful change they had undergone 

 was occasioned by the marrow having acquired 

 a dissolving quality; for it was evident the 

 dissolution began internally by the bony laminae 

 remaining here and there on the outside and 

 no where else, and the pain in the beginning 

 of the disease not being increased by external 

 pressure." 



Mr. Wilson* met with three cases, of one 

 of which he gives the dissection, which in 

 some respects resembles the preceding. As it 

 exhibited the symptom of fragility, indeed the 

 symptoms throughout were rather such as 

 should appertain to fragilitas than mollities, 

 for most of the bones of the skeleton had given 

 way, some of which were imperfectly united, 

 and many not at all, as the bones were altered 

 into a substance not very unlike that described 

 by Gooch, and as the disease evidently com- 

 menced within, we subjoin an extract from 

 the dissection, which will be sufficient without 

 entering into the more minute details. 



: All the bones were diseased. The ossa 

 brachiorum were so soft that I very readily 

 divided them with a common scalpel from their 

 heads until near the condyles. Immediately 

 at the condyles both bones were hard, and the 

 articulating cartilages had a natural healthy 

 appearance; both bones had been fractured; 

 in one the fracture had not united, and in the 

 other there were several fractures which had 

 united very imperfectly. The compact sub- 

 stance of the bone was in some places not 



* Wilson's Lectures on the Bones and Joints, 

 p. 253. 



thicker than an egg-shell : the cancelli were 

 totally destroyed, and the cavities in the mid- 

 dle of the bones were filled up with a substance 

 which seemed to have been originally extra- 

 vasated and coagulated blood, but which had 

 become vascular, and had much oil deposited 

 in the cells within it. These substances ap- 

 peared to have produced absorption of part of 

 the bone from their enlargement and internal 

 pressure, for in some places the external surface 

 of the bone was removed and tumours allowed 

 to extend through the openings." 



In confirmation of the opinion that this 

 disease is produced by some malignant taint in 

 the constitution, it may be proper to add that 

 hitherto it has baffled every mode of treatment. 

 It continues its progress without stop or inter- 

 ruption, and is inevitably fatal. 



Inflammation osteitis. The exact process 

 that is carried on within an inflamed part* 

 seems not to be satisfactorily understood, al- 

 though the subject has exercised the ingenuity 

 and employed the research of many who have 

 distinguished themselves in the cultivation of 

 pathological science. If this position is true 

 with regard to the softer and more external 

 structures which are open to examination both 

 by the touch and eye, it must be still more so 

 with reference to the osseous system, the parts 

 of which are more or less deep-seated and 

 concealed from observation. We know, how- 

 ever, that the process of inflammation is greatly 

 modified by the structure of the part affected, 

 or perhaps more particularly by its vascular 

 organization, some powerfully resisting the 

 inroads of disease, and repairing its ravages 

 with wonderful activity, while others exhibit 

 as remarkable a want of energy, seem scarcely 

 capable of a struggle, and run at once into 

 mortification. But as the bones, besides their 

 animal ingredients, contain an earthy material 

 which must exert considerable influence on the 

 phenomena, the progress, and the results of 

 inflammation, it will be necessary to examine 

 the subject with reference to the nature of the 

 structure particularly affected. 



A bone in its healthy condition is copiously 

 supplied with bloodvessels. f When examined 

 on its external surface stripped of its perios- 

 teum, it exhibits a bluish-grey colour, evidently 

 produced by a quantity of blood contained 

 within it. When it is cut, or when the perios- 

 teum is torn from it, a number of bloody 

 specks are seen ; and the cancellated structure 

 in which the marrow is lodged is always red, 

 particularly in young subjects. By Mr. How- 

 ship's observations it appears that " the small 

 space occupied by the bloodvessels of the 

 canals (within the bones) compared with that 

 which is found to be allotted to the secretions 

 and membranes of these cavities, distinctly 

 proves that the circulation must, under all 

 circumstances, enjoy as much freedom here as 

 elsewhere ; and the intimate connexion formed 

 by these canals between all parts of the bones 



* Generally spoken of as the proximate cause of 

 inflammation. 



t See Howship's Papers in the Mcdico-Chirurgi- 

 cal Transactions. 



