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Bed 10, a thick bed of rather bright green, indurated mudstone or tuff, with a concretionary nodular structure so strongly developed that the whole mass consists of balls. I will not attempt to estimate the thickness of the strata in the gypseous formation hitherto described, but it must certainly be very many hundred feet.
Clinically, the condition resembles tuberculous disease of the synovial membrane, for which it is probably frequently mistaken, but in the syphilitic affection the swelling is nodular and uneven, and the subjective symptoms are slight, mobility is little impaired, and yet the deformity is considerable.
The mass has a nodular structure, and is divided by only a few planes of stratification: there are, however, two layers, each about eighteen inches thick, of a dark brown, finer-grained stone, having a conchoidal, semi-porcellanic fracture, which can be followed with the eye for some miles across the country.
According to Senn, Heusinger records the case of a sailor of twenty-three in whom all the nerves were affected by numerous nodular enlargements. Not a nerve in the entire body was found normal. The enlargement was caused by increase in the connective tissue, the axis-cylinders being normal. In this case there was neither pain nor tenderness.
In later years the tibia may present alterations in shape resulting from antecedent gummatous disease for example, nodular thickenings of the shaft, flattening of the crest, or a more uniform increase in thickness and length of the shaft of the bone, which, when it is curved in addition, is described as the "sabre-blade" deformity.
The fruits are most various, and every hidden or patent fancy of the gourmet seems elicited or satisfied in them. I cannot now describe them even if I recalled them. One commended itself to my taste strongly, a sort of nodular banana, holding a fragrant nucleus, like a large strawberry immersed in a savory juice, and coated with a rind stripped from it by the hand.
The accumulation of urates may result in the formation of visible nodular swellings, varying in size from a pea to a cherry, attached to the tendon and moving with it. They may be merely unsightly, or they may interfere with the use of the tendon. Recurrent attacks of inflammation are prone to occur. We have removed such gouty masses with satisfactory results. Suppurative Teno-synovitis.
Dauboeuf, Garraway, Hemming, Skinner, and Cobner mention roseola and scarlatiniform erythema after minute doses of quinin. In nearly all these cases the accompanying symptoms were different. Heusinger speaks of a lady who, after taking 1/2 grain of quinin, experienced headache, nausea, intense burning, and edema, together with nodular erythema on the eyelids, cheeks, and portion of the forehead.
Bed 6, purplish, coarse-grained, hard sandstone, with broken crystals of feldspar and crystallised particles of carbonate of lime; it possesses a slightly nodular structure. Bed 7, blackish-grey, much indurated, calcareous mudstone, with extraneous particles of unequal size; the whole being in parts finely brecciated. In this mass there is a stratum, twenty feet in thickness, of impure gypsum.
Dissection showed on the right side a series of loosely attached nodular grafts of testicular tissue, in total volume about the size of a haricot bean: on the left side two small nodules, together about the size of a pea, and two other grafts at the root of the liver and on the mesentery.
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