A treatise on venereal diseases / by A. Vidal (de Cassis) ; translated, with annotations, by George C. Blackman.
- Auguste Vidal de Cassis
- Date:
- 1874
Licence: Public Domain Mark
Credit: A treatise on venereal diseases / by A. Vidal (de Cassis) ; translated, with annotations, by George C. Blackman. 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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![grows on tlie portions of tlie skeleton just mentioned, is not dis- tinctly circumscribed; it is rather an engorgement, the most promi- nent part of which is round, and the boundaries of which are insensibly lost in the adjacent tissues. The color of the skin is at first unchanged. Sometimes, there are several periostoses on a single bone, on the tibia or on a flat bone; they are then smallei, there is a doughy feel around them, and yet the color of the skin is unchanged; their progress is ordinarily, but not always, rapid, and, most generally, the pain which is severe, is still exasperated by pressure and by every movement of the corresponding bone. The tumor or tumors are much less distinct, much more diflEicult of diagnosis than when they spring from a bone deeply covered by muscular layers, as is the case with the femur. If the tumors are more superficial, so that they may be directly examined, we find them of a doughy feel; then we detect a certain degree of fluctuation; the skin at first sound, and movable over the tumor, finally adheres to it, becomes changed, and ulcerated if the disease terminate in suppuration. But this is far from being the most frequent result; periostosis, on the contrary, may termi- nate in complete resolution; it may also lead to the formation of exostosis, and this is a frequent result; this is the variety which I shall describe under the name of exostosis epiphysaire. According to M. Ricord, periostosis may present itself under three different forms: 1st. The first variety, often of a very indolent nature, but rapid in its development, is generally of long duration, and terminates in complete resolution. The tumor contains a serous, or a sero- albuminous fluid, resembling, in some instances, scrofulous pus, and in others, synovial fluid. 2d. The second variety pursues the course of inflammatory tumors ; it is acute, and well marked, or it is sub-acute. Suppura- tion sooner or later occurs, and it is rare then that subjacent bone is not primarily or secondarily affected. Zdi. The third variety, of slower development, is, nevertheless, frequently very painful on pressure, and even when it is not touched. The tumor then consists of interlamellar plastic effu- sions, which may be the rudiments of exostoses, which we shall presently consider. [The degree of hardness of a node, says Mr. Stanley, does not with certainty indicate its composition. He states that he has examined those which, from their hardness, were supposed to be osseous, but found them to consist of indurated periosteum - - G. C. B.] 1 have already spoken of lesions of the periosteum and bone, of which there are no external signs, and which may produce the pains which I have already described. These internal tumors, when developed within the cavity of the cranium, cause disorders of a still more serious character, and here the dura mater, which is the internal periosteum, may play an important part. M. Eeeve, in a work entitled, Syphilitic Meningitis, has reported a case which would seem to belong to this class. It is as follows :](https://iiif.wellcomecollection.org/image/b21082340_0442.jp2/full/800%2C/0/default.jpg)
