Page:A Treatise on the Diseases of the Bones.djvu/26

10 rant the pathologist in distinguishing simple superficial from simple deep-seated inflammation of bones.

Simple inflammation of the superficies of bone is recognized on dissection by thickening of its enveloping periosteum. The vessels, too, of this membrane, are gorged with blood; and they can, on raising it gently, be traced penetrating into the substance of the bone. This appearance is more especially observable in those bones which are throughout of a spongy or cellular texture, and in the extremities of the long bones.

In some cases I have observed minute bloody points on raising the periosteum, and this appearance is most evident in those parts of a bone which are in the immediate vicinity of joints, or which are covered by the synovial membrane. Indeed we rarely meet with acute idiopathic inflammation in the surface of bones which are dense in their structure, or which are covered by a large mass of muscles. It is in the chronic idiopathic inflammation of bone, that the peculiar gorged state of the vessels is most apparent, and this engorgement is occasionally so palpable, as to justify one in supposing that it depends in some mea-