1870, ] — [Pepper. 
‘The other epiphyses show occasionally still slighter disease. Indeed it is 
a question whether this be not the result of the prolonged boiling. The 
bones of the trunk are but little affected except the sternum, which must 
have suffered severely, the manubrium being very porous and much 
thickened. The bones of the head are scarcely at all affected. 
The point of greatest development of the disease varies with its char- 
acter. 1°. The thickening is most developed in the middle of the shafts, 
and here generally the sclerosis is furthest advanced. (Figs. 3, 4, 5, 21.) 
20, The porosity is not noticeably greater in any particular parts of the 
shafts, but seems externally to be equally diffused. 3°. The osteophytes 
follow a marked law in their development. They are most developed 
where the muscles, aponeuroses, fasciae, &c., are attached, ¢. g. the 
linea aspera, interosseus ridges of the tibia and fibula, radius and ulna, 
the insertion of the deltoid, biceps and brachialis anticus, the condyloid 
ridges of the humerus. But it is not always true conversely, that 
where a large muscle is attached there must be a large osteophyte 
growth, ¢. g. there are none at the origins of the pectoralis major 
and sterno-mastoid, the supra- and infra-spinatus, the insertion of the 
-‘quadratus femoris, &c. One class of exceptions is, however, to be 
noted, viz: that at the attachment of those muscles and ligaments that 
are connected to epiphyses, there is generally no disease, ¢. y. the muscu- 
lar attachments to the greater and lesser trochanters, the greater and 
lesser tuberosities, tubercle of the tibia, the tuber iscbii and nearly all 
the ligaments. The epiphyses and their attached parts are very nearly 
all quite free from disease, though it may be largely developed in their 
immediate neighborhood. 
The direction of the nutritious artery seems to have had no influence 
‘on the development of the disease either in its extent or degree. 
The porosity varies in its character, and usually any one bone will show 
all its varieties. 1°. The surface of the bone presents a very fine cribri- 
form appearance, resembling pumice stone. When magnified six or eight 
times this is seen to consist of a stout network of bone perforated by nu- 
merous small foramina, which are generally tolerably circular, and do not 
communicate one with another. (Fig. 24.) 2°. It may be of a finer vel- 
vety appearance. This by the same power is seen to consist of the same 
network of bone, whose very large foramina or meshes now communi- 
cate and are therefore very irregular in form, while the ridges forming 
the bony net-work are very thin and form relatively high walls between 
the adjacent meshes. Sometimes these ridges assume a tolerably regu- 
lar parallelism, giving a striated appearance to the part. 3°. A coarser 
appearance is often produced by a similar honey-combing with large 
foramina or meshes, deep and irregular, varying in size from a horse-hair 
to a line in diameter with the first or second variety existing in the inter- 
vening ridges. (See lower end of Humerus, Fig. 1.) 4°. The surface is 
-often pierced more or less sparsely by small foramina about the size of a 
shorse-hair. (Fig. 20.) 
The osteophytes vary greatly also in their character. In shape they 
