58 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 6 1 



disease, but an indication of some systemic disorder, and this was < 

 more likely of toxic than of nutritive or degenerative nature. The 

 disorder was often fatal and that mostly before the changes in the 

 skull reached their maximum ; but in a fair percentage of cases 

 the subject recovered. The changes on the skull were characterized 

 by considerable symmetry, by limitation to a very large extent to the 

 outer surface, by invasion of only those parts which do not give at- 

 tachment to muscles, and by the avoidance of the sutures as well as 

 the facial portions, thus differing radically from such diffuse osteo- 

 poroses as described in apes by v. Hansemann. The process began. 

 as can well be seen from the numerous specimens, in the roof of the 

 orbits, or on each side of the frontal squama, between the frontal 

 tuberosity and the coronal suture. In the orbits it began by an in- 

 crease of vascularity, followed by deposition of porous tissue, which 

 in extreme cases came to look exactly like a low growth of coral. On 

 the frontal the first changes were more like those of localized peri- 

 ostitis, but eventually led also to more or less surface osteoporosis. 

 Following the frontal, more exclusively osteoporotic manifestations 

 developed on the posterior portion of each parietal, between the tem- 

 poral crest and the sagittal suture, and on the occipital above the 

 crest (see pis. 24,25). If the condition still advanced, then the wings 

 of the sphenoid, parts of the temporals and parts of the base with the 

 palate began to show signs of proliferation and fine osteoporosis, 

 while localized breaking down of the altered tissue may have taken 

 place in one or more of the older lesions. These were evidently the 

 limits of the bone changes. If recovery took place, there was some 

 thickening of the affected parts of the skull, disappearance of all 

 overgrowths, and a persistence of more or less of a sieve-like condi- 

 tion of the altered surfaces (pi. 25). The rest of the skeleton, as 

 already stated, was either unaffected or affected but slightly. 



The condition here briefly described was not rachitic, for rachitis 

 did not exist in the pre-Columbian Indian. It cannot be assumed to 

 have been syphilitic, for in no case were there any other manifesta- 

 tions present that would point to that disease, and its clinical picture 

 does not correspond to that of hereditary syphilis in the infant — there 

 were no nodes nor any intracranial lesions on any infant's or child's 

 head among the many examined, whether with or without osteopo- 

 rosis, and the recoveries left results unknown in syphilis. Nor was 

 it a part of a tuberculous affection, for the lesions differ greatly 

 from those of this disease. The only conclusion the writer can 



