American practice of surgery : a complete system of the science and art of surgery . Fio. 164.—Cranium of an Indian, showing Absorption of the Frontal Bone by Syphilitic l. s. Army Medical Museum, Washington, D. (.> that portions of hone are separated as sequestra and may lie recognized as roughmasses on palpation. They sometimes require operation for removal, and inmany instance- fracture results from the loss of bony substance. In othercases, where the sequestra have not been expelled, union of the fractured frag-ments will take place. Atrophy of bony substance, in contra
American practice of surgery : a complete system of the science and art of surgery . Fio. 164.—Cranium of an Indian, showing Absorption of the Frontal Bone by Syphilitic l. s. Army Medical Museum, Washington, D. (.> that portions of hone are separated as sequestra and may lie recognized as roughmasses on palpation. They sometimes require operation for removal, and inmany instance- fracture results from the loss of bony substance. In othercases, where the sequestra have not been expelled, union of the fractured frag-ments will take place. Atrophy of bony substance, in contradistinction to SYPHILITIC DISEASE OF THE BONES. 373 osteoporosis, may be seen in one or all of the bones, but it is more probably dueto malnutrition than to any direct action of the virus of syphilis, althoughsome authorities do not accept this Pre, of a Female, showing the Inner Tableof the Frontal Bone Co- ewith Exostoses that vary in thickness from one-half to one-exghth of an ^ ^^^ \ ^^that exososeshad formed on the lower part of the right orbit and on the upper portion of the nghtlarybone. (From U. S. Army Medical Museum, Washington, D. C.) As has been mentioned, the caries in syphilis is more or less characteristicand is usually of the dry variety, in which no fluid exudes between the pen- :;74 AMERICAN PRACTICE OF SURGERY. osteum and the bone. It occurs chiefly on the cranial vault, in isolated spotsboth on theexternal and the internal surfaces of the skull. Under the influenceexerted by the new formation of blood-vessels that advances from the duraor the pericranium, the bone trabecule become absorbed and there is
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