Mollities ossium in insanity / by W. Carmichael M'Intosh.

  • M'Intosh, W. Carmichael (William Carmichael), 1838-1931.
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: Mollities ossium in insanity / by W. Carmichael M'Intosh. Source: Wellcome Collection.

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    being supplied by the fatty fluid, which readily welled out at any aperture. The costal cartilages were, in the best marked cases, altered in structure, and running laterally without interruption to a much greater extent than usual, or rather the osseous arch had also become quite degenerated in its neighbourhood, rendering the line of demarcation indistinct. When the periosteum was peeled off the edge of the degenerating bone next the softened portions, the sur¬ face was seen to be pitted with numerous large apertures, as if the osseous texture around the canals of the nutrient vessels had been the first to give way. On making a section of the portions next the costal cartilages, the incision could be carried back—even through what seemed osseous substance, so thin were the tables and so scanty the earthy matter. Isolated portions of bone mixed with the fibrous stroma, marked the gradual dissolution of the texture. Mi¬ croscopically, this part presented an interesting appearance, since in the sections many small osseous nodules of degenerating bone were included. The general field was fibro-cellular, the cells being of various shapes and sizes, nucleated and often elliptical. Amongst these and the fibres were various granules and globules of oil, and, indeed, the fatty element wras in great abundance,—the globules floating here and there and coalescing with one another as they met. The osseous portions were conspicuous on account of their different refracting power and structure. Most authorities agree that the bones affected with this disease have their lacunae enlarged. The microscopic appearance of the isolated nodules and scales of bone from the softened and fibrous regions of the ribs wTas interesting. Scarcely a normal lacuna could be seen, all bearing resemblance to such being altered and rounded, with only a trace of short canaliculi. These canaliculi had disappeared altogether for some portion, as the bone cell though widened could not have obliterated nearly so much. From these specimens, it would seem that the change of structure takes place, not in the bone lacunas only, nor in the surrounding matrix only, but in both,—a fact supported by other evidence, since the whole surrounding texture is altered in such well-marked examples, and presents dark markings and a dingy granular aspect where no lacunas ever existed. In such portions the structure is remarkable, for the field is covered with irregular dark streaks, often of large size, which are apparently cavities filled with oil. One may observe various stages in the formation of these darkened portions:—ls£, The lacuna nearly of its normal form with long canaliculi; 2d, The rounded or irregular lacuna with very short canaliculi; 3d, The latter meeting with one or several of its neighbours in a like condition forms irregular islands, each connected to the other at first by a narrow isthmus, and finally merging into extensive darkened masses. But all this seems to be favoured by the altered molecular state of the surrounding matrix, which the disappearance of part of the canaliculi with other things plainly shows to be