Licence: Public Domain Mark
Credit: Outlines of human pathology / by Herbert Mayo. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![which time the sinus had healed, and the pain, tumefaction, and redness had disappeared. 2. Syphihtic caries, as the name expresses, is an affec- tion of the bones resulting from the poison of lues. It at- tacks indifferently the shafts of the cylindrical bones and the flat bones; but not the round bones, nor the articular extremities of the cylindrical bones. It begins with inflam- mation of the periosteum : it does not lead to much enlarge- ment of bone. The bones commonly attacked are those which, lying near the surface, are obnoxious to cold : the tibia, for instance, the ulna, the clavicle, the cranial bones. The swelling, by which syphilitic caries first manifests itself, is called a node. It is an inflammation either con- fined to the periosteum, or involving at most the cortex of the bone. The periosteum becomes thickened, and is ex- quisitely painful. If the integuments are divided down to the bone at this period, a thick, viscid, glairy matter, like honey, is often found in cells of the periosteum. A node is commonly oblong, from two to three or four inches in length. There are generally more than one : it is not un- frequent to see two upon one bone. [d. Q3. 66. 67.] The surface of the bone now gradually enlarges, or is thrown up in patches of porous bone, either furrowed by longitu- dinal grooves, or spongy and sievelike, riddled with innu- merable minute holes. This appearance is very common upon the tibia, ulna, clavicle {d. 65. QQ.I; and I have seen it upon the inner table of the skull. The outer table of the skull, in venereal caries, generally has the appearance of being worm-eaten, {d. 68,] Sometimes, but rarely, the scapulae [d. 71.], and even the vertebrae, and the tarsal and carpal bones are attacked, [d. 72.] While the caries of the bone is making progress, the integuments covering it inflame; matter forms below the skin, which after a time ulcerates. The skin, before breaking, has a livid colour; afterwards the skin sur- rounding the ulcer has tlie same hue. The edges of the ulcer are commonly a little raised; its outline is irre- gular, and its surface is covered with unhealthy granula-](https://iiif.wellcomecollection.org/image/b21066735_0076.jp2/full/800%2C/0/default.jpg)
