having evidently, co-existed.
The form of the pelvis in mollities ossium necessarily varies with the
peculiar circumstances under which the individual is placed: thus, if her
strength allows her to sit up, or even to get about, as is generally the
case more or less, the promontory and the pubic bones are gradually
pressed towards each other, so that the antero-posterior diameter is
greatly diminished:[123] if, however, she is confined entirely to bed for
a considerable period, the distortion takes a different and much rarer
form. From her lying first on one side and then on the other, the pelvis
is laterally compressed; the transverse diameter becomes even shorter than
the antero-posterior; and if the disease continues long enough, the pelvis
is at length so altered and mis-shapen, that nearly all its original
configuration is obliterated. The weight of such a pelvis varies
considerably: where the disease has ceased some time before death, and
bone earth has been again deposited, there will be little difference in
this respect from a natural healthy pelvis; but if the patient has died
with the disease in full activity, its weight will be greatly diminished,
amounting sometimes only to a few ounces.
Mollities ossium, to a slight extent, we believe, is not very uncommon,
although cases of extreme deformity from this cause are of rare
occurrence. Mr. Barlow states, that "eight cases of this species of
progressive deformity have fallen under my notice, in one of which the
projection of the last lumbar vertebra at its union with the angle of the
sacrum was so much bent forwards into the cavity of the pelvis, that on
the introduction of the fore-finger up the vagina, a protuberance was
presented to the touch very much resembling the head of the foetus pretty
far advanced into its cavity. On carrying the finger a little anteriorly
past the projection, I could with difficulty ascertain the head of the
child: but on moving it around, the distortion appeared so great, that the
whole circumference did not exceed that of a half-crown piece. This
occurrence was on the 29th of April, 1792, at which time I delivered the
woman with the crotchet, and the bones of the pelvis receded considerably
to the impulsive efforts during the extraction of the head of the foetus;
yet, notwithstanding, the flexibility of the bones of the pelvis, and the
debilitated state of her constitution, she recovered speedily and without
interruption." On the 2d February, 1794, being in the neighbourhood, and
learning that she was still alive, Mr. Barlow visited her and requested an
examination. "I found her unable to walk without assistance, and as she
sat, her breast and knees were almost in contact with each other. The
superior aperture was nearly in the same state as when I delivered her
with the crotchet, but the outlet appeared more contracted, the rami of
the pubes overreached, leaving a small opening under the symphysis barely
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