American practice of surgery : a complete system of the science and art of surgery . andirregular {concentric atrophy)(see Fig. 62). Should the proc-ess go on mainly about themedullary cavity, the externalconfiguration of the bone is notaltered, but the marrow spaceis enlarged and the bone becomesthinner (excentric atrophy). Instill other cases the compactportion of the bone becomesporous, owing to the wideningof the Haversian canals (osteo-porosis) (see Fig. 63). Atrophied bones are light,fragile, easily broken or medullary substance is of-ten lymphoid in character, fatty,or the fat
American practice of surgery : a complete system of the science and art of surgery . andirregular {concentric atrophy)(see Fig. 62). Should the proc-ess go on mainly about themedullary cavity, the externalconfiguration of the bone is notaltered, but the marrow spaceis enlarged and the bone becomesthinner (excentric atrophy). Instill other cases the compactportion of the bone becomesporous, owing to the wideningof the Haversian canals (osteo-porosis) (see Fig. 63). Atrophied bones are light,fragile, easily broken or medullary substance is of-ten lymphoid in character, fatty,or the fat may be replaced by agelatinous-looking material (ser-ous atrophy). Senile and marantic atrophymay affect the skeleton as a whole, but the senile form is apt to attack moreextensively the flat bones, the calvarium, maxilla?, scapula?, and pelvis. Theprocess begins and is most marked at the points devoid of muscular to the diminution in size of the vertebra? and the intervertebral discs, theheight of the body is dimmished and the back becomes curved. The character-. FiG. 63.—Femur Cut Longitudinally, to show Rare-faction, Osteosclerosis, and New Growth of Bone from thePeriosteum. Case of Osteomyelitis. (Pathological Mu-seum, McGill Universitij.) 174 AMERICAN PRACTICE OF SURGERY istic senile facies is due to the absorption of the alveolar processes. Atrophyfrom disuse is more usually found in the limbs. The atrophy that affects the bones after amputation is from without andleads to the end of the bone becoming thinner and more pointed. Striking instances of atrophy from pressure are met with in cases of carci-noma and sarcoma developing within a bone. Not only is the bone rarefiedbut the structure is expanded. This is the cause of the so-called egg-shell crackle, which is one of theclinical featm-es looked for (seeFig. 64). From the point of view ofstructure the bones may be re-garded as consisting of a livingmatrix, in which is deposited aninert, dead material,
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