1978 



DISEASES OF BONES 



Climatology. — The disease is known in the northern portion of 

 Australia, the islands of the Torres Straits, in the Sudan, in 

 British New Guinea. 



etiology.- — This is unknown. It is not syphilitic, tubercular, 

 osteomalacic, nor due to rickets. Black considers the condition to 

 be due to hypof unction of the thymus gland. A clinically similar 

 condition is undoubtedly a late manifestation of yaws. 



Pathology. — The disease is believed to begin as a rarefying 

 osteitis which causes softening and permits the bending of the bones. 

 This is followed by a condensing osteitis and formation of periosteal 

 bone fixing the deformities. 



Morbid Anatomy. — The bending in the tibia takes place at the 

 junction of the upper with the middle thirds. The bone is heavy, 

 and compact in the centre and freer at the ends. The narrow cavity 

 is almost filled in with compact bone. 



Fig. 792. — Boomerang Disease. 

 (From a photograph by Christopherson.) 



Symptomatology.- — The onset is gradual in young natives during 

 the period of growth. There are pains in the shins, severe enough 

 to prevent walking, and the skin over these bones is tender. The 

 subcutaneous tissues become inflamed, and there is some febrile 

 disturbance. After the acute symptoms and pain have subsided 

 the children start to walk, and the bones bend forward gradually, 

 thus giving rise to the characteristic deformity, which becomes 

 permanently fixed. 



Other bones may become similarly affected. 



Treatment. — This is nil at present. 



Prophylaxis. — Unknown. 



PES GIGAS. 



Synonym. — Congenital partial hypertrophy of the foot. 



Definition. — Hypertrophy and fusion of the inner metatarsal 

 bones, with club formation of the ends of the toes. 



History. — Cousland, in the Journal of Tropical Medicine for 

 January, 1900, gave an illustration of the disease as seen in a young 

 Chinaman. Raynaud saw the disease in a Kabyle and Legrand in a 

 European. 



Symptomatology. — The condition is congenital, and may be 

 studied by the X rays, when it will be seen that the three inner meta- 



