OS'TEOIVIALATIA (Neo-Lat., from (. bo-rlov, osteon, bone p.aXada, inalak'-•. so ;s.
from AciNakOs, nialakos, soft), MottmE:: 0 or MALACOSTEON. A disease of adult lift, e terized by progressive softening of the various parts of the skeleton, with resulting deformities.
It is very rarely seen in children or old persons.
Li the great majority of cases it affects women, chiefly those who have borne children or who are pregnant. It usually progresses from bad to worse, and after perbaps a number of years it causes death, chiefly from exhaustion or com plicating disease of the lungs. It has been attrib uted to the action of many effuses, such as defec tive nutrition, excess of lactic acid, di-ease of the trophie nerves, ovarian and uterine changes, etc.; in many cases the real exciting cause is uncer tain.
The changes in the bony tissue are: Great in crease in vascularity, with resulting hemor rhages; then there is 'degeneration of the medulla or the marrow of the bone, so that it finally be comes converted into a pulp-like substance: then there is destruction of the cancellous or spongy tissue of the bone, so that cavities or tumorlike enlargements result. The periosteum is ordina rily thicker and more vascular than normal. and serves as a protecting envelope to the broken down bone. Fracture of the bone from no other cause than muscular action or a slight movement is of frequent occurrence, and deformity—some times very excessive and peculiar—is sure to be produced in other than the mildest cases.
Until deformity has occurred. or until at least the softening has advanced so far as to permit of the bone being bent, the diagnosis is difficult and uncertain, since the progress of the disease is tor a long dine an insidious one. Because of the early developed and persistent pain, the affec tion may be mistaken for rheumatism; but the multiplicity of painful areas, the sex of the pa tient, the existence of pregnancy, and the presence of large quantities of the salts of lime in the urine should direct suspicion to osteonialacia. Though this disease may not for a time exert any unfavorable influence upon life, the prognosis is grave, for the disease usually ends fatally. However, it occasionally ceases to advance, and it has even been overcome. Medical treatment— the use of phosphorus and the phosphates. the lime salts, cod-liver oil, etc.—has proved of little or no value. The best possible hygienic surround ings should be secured and the patient kept quiet and free from pain. Proper retentive dressing should be applied to prevent fracture and lessen deformity. It is reported that in some eases the removal of the ovaries and uterus has been bene ficial. In any event pregnancy should be pre vented, as childbearing exerts a powerful and deleterious influence upon the progress of the disease.