In 
Pepper.] 26 [Dec. 2, 
body similarly affected, principally between the mental foramen and the 
external oblique line. Alveoli like those of the upper jaw. This bone 
has suffered more than any other bone of the skull. 
Condition of Teeth.—The teeth were all present, and were carefully ex- 
amined. They were very brittle, so as to break across with little difficulty 
(see Micros. Hx.), but presented no peculiarity of shape. The entire ab- 
sence of the peculiar deformity of the incisors, noted by Hutchinson, of 
London, as characteristic of hereditary syphilis, is to be especially marked 
as it bears upon the question of causation of the morbid process. 
2. Vertebrw.—The epiphysal plates of the bodies, and the epiphyses of 
the transverse and spinous processes, are all gone. In the dorsal region 
the groove between the three original parts in which the ossification takes 
place, is very deep, but they are all united more or less. This groove 
gradually disappears both above and below, none of the remaining cervi- 
cal vertebree showing it, while inferiorily it is visible as far as the first 
sacral. On section the body is not much thickened, and no line of de- 
marcation exists. No sclerosis has taken place. 
(a) Cervical. Scarcely noticeable porosity of the anterior surface of 
body. Posterior arch of atlas is unusually thick and dense. 
(b) Dorsal. Marked porosity of external surface of body, which is 
elevated above the surface left by the removal of the slightly overlapping 
epiphysal plates, about one-half a line to a line. Spinous processes 
slightly porous. 
(c) Lumbar and Sacral. Same as dorsal ; the porosity of spinous pro- 
cesses being more marked. 
3. Sternum and Ribs.—(a) The manubrium only is present, and is very 
thick and porous. No osteophytes. 
(b) The ribs have lost all their epiphyses. They are not affected on the 
external surface, save slightly in one or two instances. On the pleural 
surface they are all porous, and often a little thickened. For about one 
inch from the head the entire bone is thickened and porous. 
4. Upper Extremities.—(a) Clavicle. The sternal epiphysis is wanting. 
Where the surface for the articulation with the acromion should be, there 
is on each side an oval cup-like depression } x 1 in, and 4 in. deep. (Fig. 
13.) Its walls are perpendicular, its floor flat, and both are covered with 
a thin layer of compact tissue resembling that which covers all the ends of 
the diaphyses of the other bones next the epiphysal cartilage. It was filled, 
when first seen, with a small mass of dried tissue resembling the epiphysal 
cartilage already described. Possibly it may have been an unusual third 
centre of ossification for this bone. It was occupied, certainly, by some 
substance separate from the shaft of the clavicle, either a third centre of 
ossification, or a projecting piece of the acromion. If the former, it is a 
yery unusual place for a supernumerary epiphysis. 
The whole bone is thickened to about twice its normal width, and its 
surface is coarsely porous throughout. At the insertion of the ligaments 
on the under surface, the porosity is quite fine and velvety. At the inner 
half of the origin of the deltoid there are twelve to twenty stout and well 
