The patient was a
boy of sixteen, who climbed up a lamp-post to get a light for his
bicycle lamp; his feet slipped off the ornamental ledge which
passed horizontally around the post about four feet from the
ground, and he fell. In the fall a lead pencil in his waistcoat
pocket caught on the ledge and was driven into the axilla,
breaking off out of sight. This was supposed to be a piece of the
clavicle, and was only discovered to be a pencil when it was
removed six weeks after.
There are several diseases of the bone having direct bearing on
the anomalies of the extremities which should have mention here.
Osteomalacia is a disease of the bones in adult life, occurring
most frequently in puerperal women, but also seen in women not in
the puerperal state, and in men. It is characterized by a
progressive softening of the bone-substance, from a gradual
absorption of the lime salts, and gives rise to considerable
deformity, and occasionally to spontaneous fracture.
Rachitis or rickets is not a disease of adult life, but of
infancy and childhood, and never occurs after the age of puberty.
It seldom begins before six months or after three years. There
are several theories as to its causation, one being that it is
due to an abnormal development of acids.
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