5 YMPTOMA TO LOG Y—BOOMERA NG BONES 



1977 



Symptomatology. — Generally the disease begins with pain in the 

 nose, or headache, which may be severe, and a bloody nasal dis- 

 charge, which may continue for some six to eight months. When 

 this is disappearing, it is noticed that there is a swelling, usually 

 symmetrically placed on either side of the nose, in the region of 

 the nasal bone and nasal process of the superior maxilla. Slowly 

 and steadily these lumps increase in size, interfering with vision 

 (it is said at times destroying the eyes), and giving rise to a hideous 

 deformity rather like a Cynocephalus monkey, and hence called 

 ' dog-nose.' When fairly well developed, an oval, bony swelling, 

 with its long axis directed downwards and outwards, is seen sym- 

 metrically placed on each side of the nose; the skin over the tumour 

 is never affected, being freely movable; and usually, when ex- 

 amined, the nasal mucosa is found to be normal, and the nasal ducts 

 are patent, but there may be swelling and even polypoid-like excres- 

 cences. Occasionally a similar growth may invade the nose, 

 partially blocking the nasal cavity. The growth, however, may 

 stop at any stage of its development, and proceed no farther. 

 Some authors describe a curvature of the tibiae as being associated 

 with the disease. 



Varieties. — Instead of being bilaterally symmetrical, the bony 

 lump may develop only on one side of the nose. Orpen has 

 described, in addition to the two usual tumours, a third in the 

 malar region. 



Diagnosis. — -The symmetrical bony swellings at the root of the 

 nose are characteristic, but must be distinguished from Brumpt's 

 pseudo-goundou of framboesial origin by the history and by the 

 inutility of salvarsan and potassium iodide. 



Treatment. — Medical treatment is useless, and removal is not 

 merely easy, but most effective, as the disease is known not to 

 have returned some six or seven years after the operation. 



Prophylaxis. — As the causation is doubtful, nothing can be said 

 under this heading. 



BOOMERANG BONES. 

 Synonym. — Boomerang leg. 



Definition. — disease of the long bones commencing gradually, 

 and associated with pain, tenderness, and longitudinal bowing of 

 the bones, which remain permanently deformed after the acute 

 symptoms have disappeared. Several conditions are apparently 

 covered by this term. 



History. — The disease was first described in the second edition 

 (1913) of this work from information received from Ernest Black. 

 He described it as seen in the aboriginal natives of the north of 

 Western Australia and the Torres Straits Islands. In 1915 Breinl 

 and Priestley gave an account of the disease as seen in Northern 

 Queensland and Western British New Guinea. In 1918 Christopher- 

 son described a similar condition as seen in the Anglo-Egyptian 

 Sudan. 



