mene iil “ 
7 mes 
— 
Or 
1870.] 39 (Pepper. 
little exact knowledge of the really essential changes which the organic, 
active portions of bones undergo in disease. 
Virchow, who was among the first to examine microscopically the con- 
dition of the bone cells in ostitis and some other diseases attended with 
rarefaction of the bone tissue, (Uber parenchymatése Entziindung ; 
Virchow’s Archiv. Bd. IV. Hft. 2: 1852, b. s. 801 to 311,) formerly 
regarded the process as essentially a degenerative one, due to the fatty 
degeneration of the bone corpuscles and the subsequent softening and 
removal of the area depending on these cells. We have already, how- 
ever, stated the view which appears most plausible in regard to the re- 
moval of the calcareous salts, and so far from fatty degeneration of the 
bone corpuscles being a constant feature in the different forms of osteo- 
porosis, it would appear from the careful researches of Ranvier (Archives 
d’ Anat. et Phys., Norm. et Path., No. 1, 1868, page 69), that this condition 
of the cells is altogether characteristic of caries and limited to that morbid 
process. On the other hand, there is every reason to presume that these 
cells are influenced by various morbid ‘causes, (inflammation, syphilis, 
rheumatism, gout, scrofula, &c.) in the same way as the other tissues of 
the body, and give rise to products more or less characteristic of the dis- 
eased action present. 
The history of the present case would appear to indicate that the na- 
ture of the disease was a rheumatic or scrofulous inflammation, but 
beyond this mere supposition we are prevented from advancing by the 
absence of any chemical and microscopical examination of the recent 
bones. 
We would here again call attention to the marked peculiarity of the 
porotic bones, fully described at pages 24 and 25, and figs. 4 and 17, al- 
though we are unable to suggest any plausible explanation of the invaria- 
bly parallel arrangement of the meshes of the porotic bone, and of the 
equally uniform vertical arrangement of the meshes of the new-formed 
sub-periosteal layers. 
2. Another important appearance present in the bones here described, 
and indeed one which is as marked and wide-spread as the osteoporosis, 
is the extensive development of bone upon the exterior of the original 
shafts. In our description of the skeleton, we have already noted the 
peculiarities of these sub-periosteal growths, and it will be remembered 
that they are in every instance limited to the body or shaft of the bones, 
and never extend on to the epiphyses, and that they usually present sey- 
eral thin lamine of imperfectly compact bone, parallel to the shaft and 
separated from it and from each other by more or less wide interspaces 
usually occupied by coarse cancellated tissue. 
lt is undoubtedly from the examination of such specimens as this that 
the mistaken idea arose that the lamelle, of which the original compact 
shaft was formed, had been pushed asunder by the great enlargement of 
its cancelli. It will, however, be seen from our description that the ap- 
