The diseases of children : a short introduction to their study / by James Frederic Goodhart.

  • Sir James Goodhart, 1st Baronet
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of children : a short introduction to their study / by James Frederic Goodhart. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    673/774 page 647
    ;ulj:iceiit c'ai'tila^e, conipaiutively healthy bone is staai on tlie one side, healtliy cai'tilage on tlie otlier, and between tlie two a layei', moi-e or less thick according; to the severity of tlie disease, of blnish or pearl-gi'ey translucent cartilage. 'I’he line of this towards the cartilage is I'cgnlar, but streaked with lai'ge vascular lines; towards the bone it is irregular, and sometimes so much so as to intersect the bone immediately adja- cent, and to appear as islands of cartilage, with vascular and calcareous points scattered about, (dn further ex- amination, the adjacent layei' of bone is seen to be paler oi' yellower than noi'inal, and more I'arefied. The superficial layer of the periosteum is unaffected—it can be peeled off the bone beneath, lea ving a continuous surface; but lieneath it, on the bone adjacent to the cartilage, there is more oi- less of a vascular soft mate- rial, prolonged upon it for a short distance, and im- perceptibly lost as the cartilage is distanced. The pearly layer of swollen cartilage causes the headinr/ of the ribs and the enlargement of the ends of the long bones so well known in rickets; and as regar<ls the former, it is always more marked on the pleural aspects, liecause the thoracic walls bend inwards at thi.s point, and make a knuckle towards the lung. The bone elsewhere is softer and more r.'irefied than usual, and the fatty appearance of the medulla is re- placed by one of a more vascular sort. Under the microscope, an excessive activity of the cartilage is observed. The cartibige cells become swollen and largely inci'oased in number ; but instead of making good bone, a process of cidcification goes on in them, and the interstices between them become filled with a \-a,sculai' marrow instead of with natural bone. 'I'hese medullary sjiaces ai-e continuous with the channels in the shaft, and thus is formed a spongy tissue, very vascular but with little bone in it. A similar ])i'Ocess goes on in the vascular fissue under the ])erio.steum : o.steoblasts may be .seen in all parts, but tliero is little bone.
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