THE BONE LESIONS OF SMALLPOX. 



By W. E. MusuKAVE and A. G. Sisosr. 



(From the Department of Clinical Medicine, Philippine Medical School, 



Manila, P. I. 



Eight patients have been admitted to our service during the past 

 year, who were suffering from deformities of the forearms and hands 

 caused by smallpox contracted during childhood. The following brief 

 abstracts of that part of the records of these patients which bears upon 

 the subject under consideration, together with photographic illustra- 

 tions showing the deformities in six of the cases are submitted.. We 

 are unable to give radiograms because there is no satisfactory Eoentgen 

 apparatus at present available in Manila. 1 



Case I {Plate I, figures 1 and 2). — A. P., Filipina, 30 years old, born in Orani, 

 Bataan, housekeeper, married, was admitted to St. Paul's Hospital July 27, 1910, 

 because of labor and was delivered of a normal child on July 27, 1910. 



The patient had a marked deformity of both forearms and hands which she 

 states had followed an attack of smallpox contracted when she was about two 

 years of age. The deformity (see figures 1 and 2) consists of a shortening of 

 both forearms together with enlargement and irregular development about the 

 elbow joints and irregular enlargements, shortening and other deformities of the 

 bones of the wrist, hands, and fingers. The musculature, circulation and nerve 

 supply in the deformed areas appear normal, except that there is some irregularity 

 in the course of the vessels and the function of the forearms and hands is awkward 

 and not complete, due to the abnormal relations about the joints and to the very 

 definite shortening of the long bones. There are no subjective symptoms of any 

 kind which may be associated with the lesions and there are no scars, contractions 

 nor other evidences of an objective character or in the history which would in- 

 dicate that the, process was the result of an acute inflammation such as is some- 

 times seen about the joints in smallpox. 



Case II (Plate II,. figure 1) . — B. P., Filipina, 19 years old, born in Orani, 

 Province of Bataan, housekeeper, married, was admitted to St. Paul's Hospital 

 July 25, 1910, because of labor and was delivered of a normal child on July 

 31, 1910. 



The patient gave a history of smallpox at the age of 8 years, as a result of 

 which she developed deformities in both forearms consisting of shortening of the 

 radius and the ulna. The shortening is more marked in the left forearm than in 

 the right. The articular surfaces in the elbow joint and in the wrist joint of the 



1 Such an apparatus has arrived and is now installed in the new Philippine 

 General Hospital. (Editor.) 



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