Un sistema di chirurgia . osservato,eventualmente combinato con il generale osteo-artrite. Ma vi è noenlargement o curvatura delle ossa lunghe e il cranio è entirelyunaffected. Ad un attento esame degli arti inferiori in un caso ofosteitis reumatoide, ossa lunghe sarà trovato molto molto ingrandita,e uniformemente curvata verso l'esterno e in avanti da una estremità di altre. Altre ossa possono anche essere colpiti, e generalmente in un sym-moda metrica; il caso precedentemente descritto (Figg. 345, 346,347) essendo del tutto eccezionale. I pazienti spesso si lamentano del dolore agli arti inferiori e della colonna vertebrale,ma non è seve

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A system of surgery . observed, combined possibly with general osteo-arthritis. But there is noenlargement or curvature of the long bones, and the skull is entirelyunaffected. On careful examination of the lower limbs in a case ofosteitis deformans, the long bones will be found very much enlarged, and uniformly curved outwards and forwards from one end to theother. Other bones may also be affected, and generally in a sym-metrical fashion; the case previously described (Figs. 345, 346, 347) being quite exceptional. The patients often complain of pain in the lower limbs and spine, but it is not severe, and is generally described as rheumatism. Thegeneral health may remain entirely unaffected, except from suchindisposition as may arise from want of exercise. Life is notmaterially shortened, except possibly from the onset of such anintercurrent malady as bronchitis, when the fixity of the chest wouldmaterially impair the patients powers of breathing. ? Treatment.—Iodide of potassium has not been found of much. 346.—The upper Extremities of the Case shown inFig. 345. 904 DISEASES OF BONES. value in osteitis deformans, either for the relief of pain or to checkthe progress of the disease. There is no particular line of treatmentto recommend other than what common sense would dictate foreach special case. ACROMEGALY. This is a name given by M. Marie *to a disease which is now recognised ashaving special characteristic features, butfor which no definite pathological causehas as yet been discovered. Symptoms.—Acromegaly may makeits appearance at almost any period of life, but is perhaps most frequent in the youngadult. It commences so insidiously thatthe patient is unable to give any exactaccount of its origin, his friends oftenbeing the first to notice the change in hisappearance. Enlargement of the handsand feet, which is chiefly due to hyper-trophy of the soft parts, is the mostcharacteristic symptom of this curiousaffection. The face is elongated and de-formed, from the

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