A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
steep, sometimes slightly thickened, and the scalp separated from the
brain only by a thin, transparent membrane, the remnant of the
periosteum. These holes can be easily found through the integument. The
finger, though ever so gently pressing down upon it, moves the cranium,
if any be left, before it; the bone feels like paper, and the sensation
as if it could be easily broken through is quite distinct and
embarrassing. Such perforations are usually quite numerous; from five
to twenty or more can often be counted. They are surrounded by normally
hard bone, and thereby can be recognized from the flexible part of the
cranium extending along the sagittal and lambdoid sutures. Where these
results of rachitical softening, craniotabes, are most prominent--that
is, on the part on which the infant is mostly reclining--the bone is
flattened, and may remain so for life, though in the majority of cases
the asymmetry will disappear. The flattening and perforations result
from the same causes--viz. softening of the bones and pressure upon the
bone between the pillow outside and the brain inside. With it go, hand
in hand, thick rachitical deposits under the hyperæmic periosteum of
other portions of the skull. Where craniotabes is largely developed on
the occipital portion, the frontal and the parietal bones (in their
anterior halves) are usually thus thickened. A cross-section with a
knife will reveal a diameter of the new osteoid material between the
periosteum and bone of one-half to one centimeter in thickness. It is
very hyperæmic--even more so than the bone itself, {148} which, when
cut into, exhibits an unusual amount of blood. Sometimes the deposits
are still larger, and are apt to change the appearance and weight of
the skull considerably after recovery has taken place and eburnation
and sclerosis have taken the place of the normal osseous tissue.
[Footnote 13: Boötius (1649), quoted by Haller (_Bibl. Med. pract._,
1779): "Infantibus caput grandescit, reliquum corpus contabescit, ossa
in articulis tument, dextrum hypochondrium tumore æquali prominet; hoc
malum multis millibus infantum molestum est" ("The infant head grows
large, the rest of the body emaciates, the articular bones swell, the
right hypochondrium is raised by a uniform tumor; this malady is a sore
affection in many thousands of infants").]
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