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
Such a case of rachitical cranial sclerosis I have described in the
_Amer. Med. Monthly_ of 1861. It was, however, by no means a mate of
the case related by E. Huschke. The latter skull was that of a girl of
seventeen years, and weighed 4117 grammes instead of the normal weight
of 600 grammes. The medullary (Havers') canaliculi were large and very
numerous on the surface, narrow and very few in the interior of the
sclerotic bones, and the osseous canaliculi were more spherical and
irregular in site and shape. The chemical composition was also
abnormal, phosphate of lime being 65.59, carbonate of lime 11.12,
sulphate of magnesia 1.14, cartilage and fat (very little), etc. 22.15
per cent. No fluorate of lime was found. Most of the bones were
exceedingly hard, but fragile when tried in small pieces; very white
inside, yellowish on the surface, the latter color being the remnant of
extravasated blood or other pigmentous matter. Another skull, in
Huschke's possession, and moderately sclerotic, weighed (lower jaw
excluded) 1075 grammes; a third, in the museum of the University of
Jena, is that of a young baboon,[14] in which all the bones covering
the hemispheres had become sclerotic.
[Footnote 14: Baboons suffer from rachitis very extensively. In the
_Transactions of the Pathological Society of London_ (xxxiv., 1883, pp.
310, 312) I. B. Sutton gives the description of two baboons, one of
which was six months, the other one year and six months old, when they
died. The careful description of the specimens exhibited leaves no
doubt as to the rachitical nature of the changes in both the periosteum
and the tissue of all the bones of the body.]
Of undoubted total cranio-sclerosis Huschke reports but ten
cases--those of Malpighi (1697), Cuvier (1822), Ribalt (1828), J.
Forster and Bojanus (1826), Ilg (1822), Kilian (1822), Otto (1822),
Vrolik (1848), Albers (1851), Huschke (1858). The disease does not
affect the auditory bones, the condyles of the maxillary and occipital
bones, nor the styloid process of the temporal bone. It is recognizable
in the posterior part of the cranium and basis cranii, but affects
mostly the bones of the face and the frontal, parietal, and cribroid
bones. Thus, the disease takes its origin in the anterior portion of
the skull, particularly in the superior maxilla, and proceeds upward
and backward, terminating in the basis cranii in the neighborhood of
the infundibulum and appendices. But two of all the cases were observed
during life. In all the disease was traced back to early life. The
chemical composition of the bones was greatly changed in all. Instead
of the normal proportion of earthy to organic material = 2.1 (or
1.5):1, it was from 3.5 to 4.4:1. Particularly the carbonate of lime
was greatly increased.
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