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Updated: June 9, 2025
Syphilitic sequestra are heavier and denser than normal bone, because sclerosis usually precedes death of the bone. The bones especially affected by gummatous disease are: the skull, the septum of the nose, the nasal bones, palate, sternum, femur, tibia, and the bones of the forearm. In the bones of the skull, gummata may form in the peri-cranium, diploë, or dura mater.
They consist in a pulsatile swelling sometimes in the supra-sternal notch, but usually towards the right side of the sternum with an increased area of dulness on percussion. With the X-rays a dark shadow is seen corresponding to the sac. Pain is usually a prominent symptom, and is largely referable to the pressure of the aneurysm on the vertebræ or the sternum, causing erosion of these bones.
Upon probing through a small fistulous opening just above the superior end of the sternum, the point of the arrow was found resting against the bone, about 1 1/2 inches below, the head lying against the trachea and esophagus, with the carotid artery, jugular vein, and nerves overlying.
Gooch gives an instance of a boy of thirteen who fell from the top of a barn upon the sharp prow of a plough, inflicting an oblique wound from the axilla to below the sternum, slightly above the insertion of the diaphragm. Several ribs were severed, and the left thoracic cavity was wholly exposed to view, showing the lungs, diaphragm, and pericardium all in motion.
The sternum. 27. The scapula, or shoulder-blade. 28. The humerus, or lower bone of the shoulder. 29. The radius, or principal bone of the arm. 40. The ulna, its upper part forming the elbow. 41. The small bones of the knee. 42. The large metacarpal or shank bone. 43. The smaller or splint bone. 44. The sessamoid bones. 45.
Miscellaneous Multiple Fractures. Westmoreland speaks of a man who was pressed between two cars, and sustained a fracture of both collar-bones and of the sternum; in addition, six or eight ribs were fractured, driven into and lacerating the lung. The heart was displaced. In spite of these terrible injuries, the man was rational when picked up, and lived nearly half a day.
Pain, disturbances of sensation, and muscular paralyses may result from pressure on nerves. Such bones as the sternum and vertebræ undergo erosion and are absorbed by the gradually increasing pressure of the aneurysm. The skin over the tumour becomes thinned and stretched, until finally a slough forms, and when it separates hæmorrhage takes place.
In five days the symptoms had all abated, and the would-be suicide was well enough to start for the Continent. Muhlig was consulted by a mason who, ten years before, had received a blow from a stiletto near the left side of the sternum.
The naturalist can tell when he picks up a skeleton something of the habits and the element of the creature to which it belonged. If it has a hollow sternum he knows it is meant to fly. On your nature is impressed unmistakably that your destiny is not to creep, but to soar.
In other respects the modifications of wings and sternum are so obviously adaptive that it is difficult to believe that the reduction of digits was not due to disuse.
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