Chapter XXXV: Section I: Of the Periosteum

[=Notice=: degree of vascularity; thickness; density; detached or
adhered; effusions beneath; serum or pus; ulcerative destruction of;
condition of bone beneath, etc.]

=Inflammation= of the periosteum occurs in the vicinity of chronic ulcers; as essential to the reproduction of bone after fractures; in consequence of syphilis or its mercurial treatment; in rheumatism; and as a manifestation of a scrofulous cachexia.

In incipient inflammation, the membrane has a reddish tinge, a humid, succulent appearance, and there is more or less of a serous effusion, causing a slight separation from the bone. As the inflammation advances, the connection between the membrane and the bone becomes more lax, and the effusion assumes a purulent character.

Syphilitic inflammation of the periosteum is apt to appear in detached spots, causing swelling, induration, the formation of new osseous matter and necrosis. The periosteum of the skull, sternum and tibia are most frequently attacked.

A malignant disease of the periosteum, the consequence of long-continued or repeated attacks of inflammation, is described by Stanley. It occurs on the bones of the hips, and gives rise to the growth of a fungous excrescence upon the membrane. “This is sometimes soft and flocculent on its surface, with a firm, grayish, gelatinous base; at others it consists throughout of a firm, gelatinous substance.”