American practice of surgery : a complete system of the science and art of surgery . dical Museum, Washington, D. C.) more permanently formed. In the irritative form of inflammation the gummahas a marked tendency to destroy bone, although resolution may still be osteomyelitis tends to caries, while pyogenic infection producesnecrosis of bone and will cause intense constitutional symptoms. In somecases, where absorption has taken place from rarefying ostitis or from caries, thebone may be reduced to great thinness and may be so frail as to fracture , this cond
American practice of surgery : a complete system of the science and art of surgery . dical Museum, Washington, D. C.) more permanently formed. In the irritative form of inflammation the gummahas a marked tendency to destroy bone, although resolution may still be osteomyelitis tends to caries, while pyogenic infection producesnecrosis of bone and will cause intense constitutional symptoms. In somecases, where absorption has taken place from rarefying ostitis or from caries, thebone may be reduced to great thinness and may be so frail as to fracture , this condition, which has been referred to under the head of Rarefy-ing Ostitis (p. 366). is not so characteristic of syphilis as is eburnation, which 372 AMERICAN PRACTICE OF SURGERY. results from condensing or productive ostitis. In the gummatous form thedeposits vary in size from that of a pins head to that of an object several inchesin diameter, and may cause caries or even necrosis within the hone, withoutaffecting the skin situated over it. Under these circumstances it often happens. 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 view.
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