Mollifies ossiuni is a disease, the phenomena of which are directly the reverse of those we have just considered. In fragilitas the bone snaps across from the most trifling causes : in mollifies it is flexible, bends in every direction, and, of course, is useless for the purposes of support or motion. The morbid condition seems to arise from a want of accordance be tween the secreting and absorbing vessels of the bones affected : if the earthy material is not secreted at all or in insufficient quantity, or if it is absorbed too rapidly, mollifies will be the consequence, and we may presume that there will be variety in the rate of its progress and in the intensity of its symptoms, according to the degree of derangement of function ex isting at different times. It may thus be easily comprehended how fragility of bone may be an early symptom of mollities, at a period when the earthy material has been removed to an extent which renders the bone completely flexible.
Of the causes that produce this curious dis ease, or of the change of structure that occurs at an early period, nothing is certainly known, indeed, it is so rare an affection that little oppor tunity for anatomical or chemical examination in any of its stages has occurred. Boyer seems to regret our deficiency in this branch of pathological knowledge, and doubts that there are a sufficient number of authentic cases to establish such a difference between the fragility and the softness of bone as to authorize them being considered distinct diseases. There can be no d-oubt that in the cases of cancer, &c. which have occasioned, or been attended by, a softening of the bones, the symptom of fra gility has been observed at one period or another, and perhaps there is 110 such thing as a softening of the bones independent of some malignant taint in the constitution. " There is scarcely any case," observes the author just quoted, " of a pure and simple softening (ramollissement) of the bones:" not one (we believe) in vvhich they have been found merely deprived of their earthy constituent, leaving the animal material healthy and unaltered, like a bone that had been prepared by macera tion in muriatic acid; whilst all the dissections of mollifies exhibit such decided alterations of structure as to justify an opinion of the exis tence of some malignant disposition in the entire system. This view of the case ought to remove the disease from the position it holds in our classification, and place it among the derangements of structure, only that there is some reason for supposing that the first and early stages may be accompanied with the absorption of the phosphate of lime, and it must therefore signify little where we place an affection, of the nature of which we are con fessedly so ignorant.
There is, however, a softness and pliability of bone (we use the word softness in opposi tion to softening) in which there is no malig nant tendency whatever. It is original and congenital, that is, from birth the process of ossification is suspended in some part or limb. We have seen two instances of this : the most remarkable occurred in a poor man forty years of age, whose right arm was perfectly flexible, and of course powerless. Ile stated that he had been so from birth, but in every other re spect had enjoyed the verybest health ; he earned his livelihood with the other arm, with which he had become wonderfully dextrous. On
the nature of the cause that could suspend a particular process of nutrition in one limb, the remainder of the body being perfectly healthy, it would be useless to speculate at present.
The most extraordinary instance of mollifies ossium on record is that of Madame Supiot. It may be found at length detailed by Brom field, to whom it was communicated by M. Supe, surgeon to the hospital of La Charite.* This woman appears to have been an in valid for fifteen years, during the first five of which she suffered from great weakness in her loins and lower extremities, accompanied by great pain, which, however, did not prevent her giving birth to two children within the time. When M. Supe saw her, " the trunk was extremely shortened, and did not exceed twenty-three inches in length. The thorax was exceedingly ill-formed, and the bones of the upper extremity were greatly distorted ; those of the lower were very much bent ; and the thigh-bones became so extremely pliable as to permit the legs to be turned upwards, insomuch that her feet lay on each side of her head. The softness of her bones daily in creased to the hour of her death." It is unne cessary to dwell -on the symptoms under which she laboured, as it must be obvious that no one viscus could perform its function properly in such an extraordinary mass of deformity as she eventually became. On dissection, M. Supe says, 44 the bones, one may truly say, had arrived at the utmost degree of softness, as we have not heard of any observations similar to this case. In effect we have, now and then, remarked that bones become mem branous and of the consistence of flesh, but I believe there never was before seen an instance of the osseous particles in the great bones of the extremities being so totally dissolved, leav ing no more than the form of a cylinder by the periosteum remaining unhurt." Mr. Goocht relates a case which lasted five years, and which at an early period exhibited the symptoms of fragility, the patient having broken her leg as she was walking from the bed to her chair and heard the bones snap. The winter after breaking her leg, she had symptoms of scurvy, and bled much at the gums, and throughout her illness her legs and thighs were cedematous, and subject to excoriate, discharg ing a thin yellow ichor. From the commence ment of the attack the bones continued to grow softer, and a year before her death " she breathed with difficulty, and the thorax ap peared so much straitened as necessarily to impede the expansion of the lungs : her spine was much distorted, and any motion of the vertebrw of the loins excited extreme pain : her legs and thighs being quite useless, she was confined to her bed in a sitting posture : the bones she rested upon, having lost their solidity, were much spread, and the ends of her fingers and thumbs, by frequent efforts to raise herself, were become very broad, with a curvature of their phalanges : she now mea sured but four feet, though before this disease she was five feet and a half high and well shaped." After death she was found wanting in her natural stature two feet and two inches.