American practice of surgery : a complete system of the science and art of surgery . Fig. 167.—Cranium Showing Destruction of the Nasal, Ethmoid, and Palatal Bones by Syphilis.(From U. S. Army Medical Museum, Washington, D. C.) ever, when condensing ostitis sets in, the nutrition may be reduced to such anextent that the tissues break down and local necrosis and suppuration these grooves and pits in the skull the condensing ostitis forms a raisedring, in marked contrast to the excavated portions. 376 AMERICAN PRACTICE OF SURGERY. Syphilitic necrosis following gummatous inflammatio
American practice of surgery : a complete system of the science and art of surgery . Fig. 167.—Cranium Showing Destruction of the Nasal, Ethmoid, and Palatal Bones by Syphilis.(From U. S. Army Medical Museum, Washington, D. C.) ever, when condensing ostitis sets in, the nutrition may be reduced to such anextent that the tissues break down and local necrosis and suppuration these grooves and pits in the skull the condensing ostitis forms a raisedring, in marked contrast to the excavated portions. 376 AMERICAN PRACTICE OF SURGERY. Syphilitic necrosis following gummatous inflammation presents to Virchow the sequestrum is separated from within outward, sothat it presents a worm-eaten appearance on its inner surface, while the ex-ternal surface is comparatively smooth. The edges of the living bone at theline of separation are swollen and thickened by the condensing ostitis in a. Fig. 16S. Fig. 169. I :•,-. 168 and 169.—Syphilitic Disease of the Right and Left Femurs (Fig. 16S) and of Both Tibias(Fig. 169). The same patient furnished the skull represented in Fig. 164. (From U. S. ArmyMedical Museum, Washington, D. C.) way very characteristic of syphilitic necrosis. Syphilitic necrosis often occursin bones of the skull and face, where it causes marked destruction. The for-mation of gummata in the region of the diploe, between the inner and outertables of the skull, often so cuts off the nutrition to the outer table by pressureas to produce extensive necrosis. When the necrosis is limited the tendency SYPHILITIC DISEASE OF THE BOXES. 377 of the sequestra is to form serpiginous or circinate margins which resemblevery much the outlines of the skin lesions in tertiary syphilis. All scars, aiter syphilitic destruction of the bone, are peculiar in one re-spect: there is no formation of bone to build up the centre of the cavity, al-
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
