. The science and art of midwifery. ion and extraction with thecranioclast should be resorted to. VII. Pelves deformed by Osteomalacia. Osteomalacia is almost confined to females, and appears, ordinarily,in the puerperal state. It usually attacks fully-developed bones, butmay, rarely, affect them during their period of growth. It is gener-ally observed in multiparas, although primiparas are in exceptional casesits victims. Each succeeding preg-nancy is usually attended by a pro-gressive development of the disease,which may, however, become non-progressive, or even be completelyand permanently
. The science and art of midwifery. ion and extraction with thecranioclast should be resorted to. VII. Pelves deformed by Osteomalacia. Osteomalacia is almost confined to females, and appears, ordinarily,in the puerperal state. It usually attacks fully-developed bones, butmay, rarely, affect them during their period of growth. It is gener-ally observed in multiparas, although primiparas are in exceptional casesits victims. Each succeeding preg-nancy is usually attended by a pro-gressive development of the disease,which may, however, become non-progressive, or even be completelyand permanently arrested, f In acase of this kind the bone is restoredto its normal histological state, al-though its deformity remains. Os-teomalacia may involve the entireosseous system, or be confined to in-dividual bones. In the latter casethe long bones and the vertebras aremost frequently In pu-erperal osteomalacia the pelvis andthe vertebras are predominantly andoften exclusively affected. The dis-ease is regarded as an osteomve-. Fig. 231. Osteomalacia. (Specimen fromWoods Museum.) * Scharlau, Monatsschr. f. Geburtsk., Bd. xxvii, 1866, p. Winckel, Monatsschr. f. Geburtsk., Bd. xxiii, 1864, p. Litzmann, Die Formen des Beckens Berlin, 1861. 526 THE PATHOLOGY OF LABOR. , litis, which, beginning in the center of bones, advances toward theirperiphery. The essential pathological process consists in the absorp-tion of calcareous matter, through the Haversian canals, and in thesubstitution of hypertrophic medullary tissue for the softened osse-ous structures.* The natural result of the changes is great friabilityor pliability of the bones, according to the stage reached by the disease,and their consequent distortion by compression or traction. The bonesare of very light weight. Their transverse section reveals a porous,diploe-like structure. Their outer, hard lamella is exceedingly thin,or entirely absent. The bones are of a wax-like softness, being readilycut and molded,
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
