A system of surgery . heresult of some added trauma-tism, or from starvation ofsome part of the bone byobliteration of its blood-vessels. Here again the process is an excessively slow one. The denuded sequestrum orcarious patch is hard and pitted, as though worm-eaten, oftenblackened by long exposure. Interference with the surgeons gougeor chisel is of use here, in order to hasten the process of very curious and interesting feature is the abnormal growth inlength which occurs when this chronic syphilitic osteitis developsand exists for some years before, or even after, puberty. T
A system of surgery . heresult of some added trauma-tism, or from starvation ofsome part of the bone byobliteration of its blood-vessels. Here again the process is an excessively slow one. The denuded sequestrum orcarious patch is hard and pitted, as though worm-eaten, oftenblackened by long exposure. Interference with the surgeons gougeor chisel is of use here, in order to hasten the process of very curious and interesting feature is the abnormal growth inlength which occurs when this chronic syphilitic osteitis developsand exists for some years before, or even after, puberty. The affectedtibia and fibula, for example, become actually longer than the femur,and remain so throughout life. The change is generally , the inflamed bone has the appearance of being bent or curved(usually forwards), and sometimes this curving is real as well asapparent. Probably from destruction of the epiphysial disk of cartilage, thebone affected with syphilitic disease may become not longer, but. Pig. 90.—Enlargement of lower half of leftHumerus, Badius, and Ulna from Osteitisand Periostitis due to inherited patient was a young woman aged twentyyears. 430 SYPHILTS. actually shorter, than normal. Fig. 85 shows well the dwarfing ofone finger that has resulted from former osteitis in a child with otherlesions of inherited syphilis. Spontaneous fracture must also be mentioned as a rare complica-tion, due to a gumma in the medullary portion which has thinned thebone, or to weakening of the latter from the surface by necrosis, etc. The bones chiefly involved (as a rule, symmetrically) are (1) thetibia (by far the most frequent and one of the most easily examined);(2) the femur, humerus, radius, and ulna; (3) the clavicle, sternum;and (4) the bones of the skull. Besides isolated nodes on the vault,which are liable to soften and to be followed by limited necrosis, andthe destructive inflammation of the nasal bones— including thevomer, turbina
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