American practice of surgery : a complete system of the science and art of surgery . there are a num-ber of these places along the same surface the whole shape and size of the bonemay be changed, and this is referred to as a hyperostosis. (Fig. 175.) The inflam-mation is sometimes so severe at first as to cause an abscess and necrosis of thebone, although it is more usual for the gummatous form to succeed this simpleperiostitis. However, the inflammation, instead of beginning in the periosteum SYPHILITIC DISEASE OF THE BONES. 371 or in the superficial layers of the bone, occasionally commences
American practice of surgery : a complete system of the science and art of surgery . there are a num-ber of these places along the same surface the whole shape and size of the bonemay be changed, and this is referred to as a hyperostosis. (Fig. 175.) The inflam-mation is sometimes so severe at first as to cause an abscess and necrosis of thebone, although it is more usual for the gummatous form to succeed this simpleperiostitis. However, the inflammation, instead of beginning in the periosteum SYPHILITIC DISEASE OF THE BONES. 371 or in the superficial layers of the bone, occasionally commences well within itssubstance, and when this happens the disease is apt to proceeed to moleculardeath of the bone and to a condition of caries, surrounded by the productiveostitis and the cburnation that are so characteristic of syphilitic disease of thebone. (Fig. 175.) Necrosis may sometimes occur. The gummatous form of in-flammation of the bone or periosteum is a later stage, in which the granulation tis-sue which ordinarily accompanies this inflammation becomes more localized and. Fig. 163.—The Vault of the Cranium, Showing Syphilitic Ulceration of the Left Parietal andthe Frontal Bone. (From U. S. Army Medical Museum, Washington, D. C.) more permanently formed. In the irritative form of inflammation the gummahas a marked tendency to destroy bone, although resolution may still be osteomyelitis tends to caries, while pyogenic infection producesnecrosis of bone and will cause intense constitutional symptoms. In somecases, where absorption has taken place from rarefying ostitis or from caries, thebone may be reduced to great thinness and may be so frail as to fracture , this condition, which has been referred to under the head of Rarefy-ing Ostitis (p. 366). is not so characteristic of syphilis as is eburnation, which 372 AMERICAN PRACTICE OF SURGERY. results from condensing or productive ostitis. In the gummatous form thedeposits vary in size
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
