A system of surgery : pathological, diagnostic, therapeutic, and operative . y most conspicuous about the countenance, especially when the disease attacks and destroys theproper bones of the nose, which then cave in, and cause that remarkable flatten-ing of the face so characteristic of the effects of tertiary syphilis. In manycases the turbinated bones, the ethmoid, and vomer are separated, so as to con-vert the nasal fossaj into one immense cavity; and instances occur where, inconsequence of the destruction of the palate and maxillary bones, the mouthand nose communicate with each other. In
A system of surgery : pathological, diagnostic, therapeutic, and operative . y most conspicuous about the countenance, especially when the disease attacks and destroys theproper bones of the nose, which then cave in, and cause that remarkable flatten-ing of the face so characteristic of the effects of tertiary syphilis. In manycases the turbinated bones, the ethmoid, and vomer are separated, so as to con-vert the nasal fossaj into one immense cavity; and instances occur where, inconsequence of the destruction of the palate and maxillary bones, the mouthand nose communicate with each other. In the long bones of the extremities,the caries and necrosis are generally superficial, the dead portions coming awayin the form of exfoliations, the central parts of these pieces seldom participatingin the morbid action to an extent sufficient to cause their destruction. The adjoining cut, fig. el, from Druitt, affords a graphic illustration of cariesof the bones of the skull, which^ as in a case that came under my observation many years ago, are sometimes so corn- Fig. Syphilitic caries of tlie skull. In cases of long standing. pletely riddled as to give them a pecu-liar cribriform appearance. Syphilitic hyjjeitrojjhy of the osse-ous tissue is extremely common, andsometimes involves the greater numberof pieces of the skeleton ; the bones,however, which are most liable to beattacked are the tibia, fibula, femur,ulna, radius, and cranium. The lesionoccurs either as an exostosis, or as adiffused swelling, which, when it affectsthe whole length and thickness of abone, assumes the name of generalhypertrophy. The mode of formationof a syphilitic exostosis presentsnothing peculiar, and need not, there-fore, claim any special attention; itevidently takes its rise in a deposit ofplasma, which serves as a nidus forthe future growth, the ossific processpassing through the same phases as inthe natural skeleton. The tumor isusually knobby and irregular, with abroad base, and a rough sca
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Keywords: ., bookcentury1800, booksubjectgeneralsurgery, booksubjectsurgery
