MOLLITIES,OSSIIIM, OSTEOAIALACIA,,a_destructive disease of the bones, char :acted zed by sottileilitig and 'fragility': baS caiefUlly studied by Curling, Solly, Stanley, McIntyre, and Litzmann, and also by Paget and Dalrymple. The bones! become bent, their extremities swollen, and their shafts broken in various parts of body. No callus follows the fracture as in healthy bone, and in consequence the body of the patient becomes much distorted. On examining the bones after death, they are found light, soft, and gritty to the feel; exceedingly brittle, and of a reddish brown color. Cavities of various sizes, and of a round or oval shape, are also found, usually filled with an oily, reddish, grunions fluid, but sometimes with clear serum. The red, grunions matter exhibits a cell development, and Sully regards it as a subsequent bid product, and not simply altered fatty matter colored with blood. Dalrymple found caudate corpuscles in it, and regards it as malignant, in which opinion others agree. Virchow, however, considers that the peculiar cellular condition results from retrograde• conversion of osseous into medullary substance. Paget regards mollifies ossium as. including two diseases—one more common in England, attended with fatty degeneration, and another called ostegporisis by the Germans, iu which there is simply removal of earthy matter, and more common n Germany and France. Ile also believes the Eng lish affection generally attacks the bones of the extremities, while that form more often seen on the. continent attacks the bones of the trunk. The cause of mollifies cesium is rather obscure, but is frequently connected with rheumatic symptoms. In some cases a. connection has been traced to syphilis. The physiological conditions which accompany it arc those of malnutrition generally, abnormal digestion, assimilation, and disassimila tion. It is a disease of adults, rarely attacking persons under 20 years of age, and the aged are also not exempt. Its subjects are more often females than males, and, in a.
majority of cases, it is connected •.vith the child-bearing state. Of 131 cases collected. by Litzmann of Kiel, there were 85 ;-males in whom the disease occurred during preg nancy, or was modified by it.. Of the remaining cases 46 were females and 11 were males. According to the same authority, the seat of the disease varies as it occurs• within the child-bearing period or not. In the 85 child-hearing women the whole skele ton was affected in 6 cases only, and all the bones except those of the head in two;_ whilst in the 46 other cases not connected with the child-bearing period, all parts of the skeleton were diseased in 21, and all the bones except those of the head in 6. The urine always contains large quantities of earthy matter, chiefly phosphate of lime, which has. been absorbed from the bony tissue and eliminated by the kidneys. The pelvis, or chamber of the kidney, is sometimes filled with phosphatic accretions, forming a solid calculus. At the commencement of the disease the diagnosis is very difficult, as the symptoms simulate those of rheumatism. It is important., however, to make the dis tinction as soon as possible, which may be done as soon as the phosphatic condition, of the urine is manifested. It is readily distinguished from rickets, as the latter peculiarly a disease of childhood, and has no tendency to spontaneous fracture of the bones. The treatment offers little encouragement, although judiciously selected tonics will sometimes afford temporary relief, and arrest for a short time the progress of tile disease; but its tendency is progressive. In the latter stages opiates are indicated to relieve pain and produce sleep, and, with wine or other stimulants, are the only medicines, required.