. The principles of surgery . ears. In some instances, it has begun immediately after birth. Itrarely, however, appears before the fifth or sixth month ; and the mostfrequent period of its commencement is between eighteen and twenty-four months. It very seldom commences after It is attend-ed, from the first, by a marked cachexy of system, which seems to beidentical with the scrofulous. Usually, however, this becomes abated,after a time ; even independently of remedial treatment. And, contem-poraneously with amendment of the general health, the abnormal condi-tion of bone also disappe
. The principles of surgery . ears. In some instances, it has begun immediately after birth. Itrarely, however, appears before the fifth or sixth month ; and the mostfrequent period of its commencement is between eighteen and twenty-four months. It very seldom commences after It is attend-ed, from the first, by a marked cachexy of system, which seems to beidentical with the scrofulous. Usually, however, this becomes abated,after a time ; even independently of remedial treatment. And, contem-poraneously with amendment of the general health, the abnormal condi-tion of bone also disappears; a fact which has most important heavingon the treatment, and which should therefore be borne constantly in re-membrance. The bone is found changed in structure. The dense laminated textureis almost entirely removed ; barely enough being left, sometimes, to con-stitute a thin outer shell. Cancellous texture, consequently, largelypredominates ; of a brown or reddish hue, soft, compressible, and at first Fig. 141. Fig. filled with a serous fluid ; in some cases a sanious liquid may be squeezedout, as if from wet leather. After some time, a gelatinous substanceoccupies the tube and cancelli; and this, becoming organized, passes 1 Stanley on the Bones, p. 218. Figs. 141 and 142. Permanent curvature of the spine, with rotation, produced byRickets.—Listen. RICKETS. 443 into a cartilaginous state. The whole bone is soft, easily cut with aknife, and preternaturally flexible. It has parted with its earthy ele-ments, and become cartilaginous instead. The animal matter too ischanged, as well as the earthy ; for the extract obtained, by boiling,does not yield either chondrin or the gelatine of bone. And, besides allthis, comparative arrest of growth takes place; especially in the lowerlimbs. Sometimes the entire bone is expanded, even to a great extent; thecalvarium for example, being in some cases found of more than doubleits usual thickness, and seeming to consist almost enti
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