This system, remarkable among all the others by the hardness and resistance that characterize it, has from this double attribute a fitness to serve as a common base for all, upon which they rest, and around which they are suspended and fixed. The whole of the pieces that form it, are connected together for this use, by means of flexible and resisting bands, which with these pieces make a whole that is called a skeleton. The osseous whole, placed in the midst of many organs that it sustains, everywhere continuous in its different parts, has not however, like the primitive systems, continuity of peculiar life from one of its extremities to the other. The bands which connect these different pieces, very different from them in their nature and their properties, produce in them an insulation of vitality, which the different parts of the above systems do not exhibit, because in their continuity their nature is everywhere the same.

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ARTICLE FIRST.
Of the Forms of the Osseous System.

Considered in relation to their forms, the bones are of three sorts, long, flat and short. One dimension predominates in the first, viz. length; two are in nearly equal proportions in the second, length and breadth; these two last dimensions, with thickness especially added, characterize the short bones. Let us examine each in a general manner.

I. Of the Long Bones.

The long bones belong in general to the apparatus of locomotion, in which they form a kind of levers that the muscles move in different directions. All are placed in the extremities, in which their whole forms a kind of central column, moveable in different directions. We see them successively diminishing in length and increasing in number, when examined from the superior to the inferior part, from the thigh or the humerus to the phalanges of the toes or the fingers. It follows from this double opposite arrangement, that the top of the limbs is characterized by the extent of its motions, and the bottom by the multiplicity, variety and narrow limits of these motions.

These bones have all an analogous conformation; thick and large at their extremities, they are more slender and usually rounded in the middle or body, as anatomists call it.

The size of the osseous extremities exhibits the double advantage, 1st, of presenting to the articulations large surfaces and consequently more causes of resistance to different displacements; 2d, of contributing to the regularity of the forms of the limb to which they belong. Observe in fact that the muscles and the bones are placed in an inverse direction in the extremities. The middle of the first, which is their largest part, corresponds to the middle of the second, which forms their small portion, whilst the extremities of these compensate by their size for the smallness of the tendons which terminate the others, and which are placed at the side of them. The increase of size of the extremities of the long bones is not sudden; it commences imperceptibly upon the body. We observe upon these different extremities eminences of articulation and of insertion.

The middle or the body has no eminence; prominent lines are seen there, always destined for aponeurotic insertions, and which, when they are very considerable take from the bone its cylindrical form, which it however preserves in the interior; thus the tibia is evidently triangular externally, though within its canal has the form of that of the femur. In general these lines of insertion, always separated by plain surfaces, are three in number upon each long bone, as we see on the humerus, the radius, the ulna, the tibia, fibula, &c. I know not the reason of this law of conformation. Another general observation is, that the body of almost all the long bones is twisted, so that the direction of its superior part is not the same as that of the inferior; by tracing from above downwards one of these lines of which I have just spoken, this may be seen; it is however more evident in the adult than in the foetus. This change of direction has no uniformity in the course it pursues.

The internal forms of the long bones are very well seen by sawing them longitudinally. The texture of the cells fills them to the extremities; it is, as we shall see, more fine and less abundant in the middle, where the medullary canal exists.

This canal does not exist in the first month of the foetus, nor as long as the bone is cartilaginous; the osseous state is the period of its formation. All the gelatine of the middle of the bone is then absorbed, exhalation brings no more there, except in the very delicate texture of the cells that this canal contains; this function, which is nothing in the centre, becomes more active on the circumference of the bone. This increase of activity of the external exhalants favours the formation of the compact texture, the development of which takes place precisely at the same time as that of the canal whose parietes it forms; so that at this period of ossification, exhalation and absorption appear to be in an inverse state in the two parts of the bone; one is very active on the exterior in bringing phosphate of lime, with which it encrusts the already existing parenchyma; the other is very active in the interior in removing the gelatine whose absence forms the space from which the medullary canal arises.

There is no well marked medullary cavity except in the humerus, the radius, the ulna, the femur, the tibia, the fibula and clavicle. The ribs and the phalanges, which in their forms resemble them, have much of the ordinary texture of the cells in their centre, and hardly ever any of that more delicate texture of the cells which occupies the centre of the bones above named, and which is only found in the medullary cavity.

This cavity does not extend beyond the body of the bone; where the compact texture grows thinner, it disappears, and is replaced by a great quantity of the texture of the cells, which fills the extremity of the bone. Its form is cylindrical and its direction straight. It does not vary in its form, on account of its asperities or the external prominent lines of the body of the bone, which is only thicker in these places. Its parietes are much smoother in the middle, than at the extremities, where there are already many considerable cellular filaments thrown off. There are in many subjects, delicate, horizontal bony partitions, which interrupt almost entirely its continuity in this place, and appear to divide it into two or three very distinct parts.

The medullary canal serves not only to lodge and defend the medullary organ, but also to give more resistance to the bone; for we know, that of two cylinders formed of an equal quantity of matter, one of which is hollow, and consequently has a greater diameter than the other which is full, the first will resist more than the second, because we can bend and break it with less facility. Full cylinders, equal in diameter to the long bones, would have prevented by their weight, the motions of the limbs; whilst other cylinders of the same weight as the present, but without any cavity, would give too small a surface for the insertion of the muscles. To unite small weight with a sufficient space in the middle of the long bones, is then a great advantage of the medullary canal.

This canal disappears in the first periods of the formation of callus in fractures, because the whole medullary organ is occupied at this place by gelatine, and becomes cartilaginous; then this gelatine gradually re-absorbed, without being replaced, favours the development of a new cavity, and the communication is re-established between the superior and inferior parts of the canal.

I have observed that, in the first age, and while the extremities of the bones are cartilaginous, the medullary canal is shorter in proportion than in the adult; it hardly forms at birth more than the middle third of the bone, the superior and inferior thirds being formed at first by the cartilaginous portion of each extremity, then a texture of cells intermediate between this portion and the canal; so that as we advance in age, its length becomes in proportion greater.

II. Of the Flat Bones.

The flat bones have in general, but little relation to locomotion, which they only assist by the insertion of the muscles that go to the long bones. Nature designs them especially to form the cavities, such as those of the cranium and the pelvis. Their conformation renders them very proper for this use. Their number varies according to the cavities with which they are connected; many always unite to form one, and it is this circumstance that contributes in part to their solidity. In fact, external blows losing their force at the place of their junction, fracture them with less ease. If the cranium was only one single piece, its solutions of continuity would be much more frequent than they now are. So that as the sutures ossify in old age, they become more brittle. In children, in whom the ossification is not complete, and the number of whose separate, osseous pieces is consequently more considerable in the head, the pelvis, &c. the difficulty of fractures is very great, because the soft bands which unite the solid parts yield to external bodies, without breaking.

The flat bones are almost all curved, concave and convex on the opposite sides; this arises from their destination in the formation of cavities. Their curve varies according to the place in the cavity they occupy; this curve is the cause of a very powerful resistance, when that mentioned above does not exist. Thus in the first age, the cranium resists by yielding; but as the sutures become more closed, and only one osseous piece is formed, it is by the mechanism of the arch that the brain is protected.

All the flat bones have two surfaces and a circumference. According as the first serve for muscular insertions, or are only covered by aponeuroses, membranes, &c. they are rough or smooth. Towards the middle the bone is thinner; it has more thickness at the circumference, which is either for articulation or insertion. In the first case, this excess of thickness gives more solidity to the joints, which are then made with larger surfaces, as we see in the cranium; in the second, it presents to the fibres more points of origin, as we see on the crista of the ilium and the greater part of its circumference.

The internal forms of the flat bones have but few peculiarities; their two external layers leave between them a space which is filled by the texture of the cells.

III. Of the Short Bones.

The short bones are placed in general in parts where are found united mobility and solidity, as in the vertebral column, the tarsus, and the metatarsus. Always small, they are in great number in the regions which they occupy; their number compensates for their size in the formation of the parts of the skeleton to which they contribute. It is this number also, that gives to these parts the union of the two almost opposite attributes of which we have spoken, viz. solidity, because the external efforts are lost in the numerous bands which unite them, and mobility, because the whole of their individual motions gives a considerable general motion.

There is nothing constant or uniform in the external conformation of these bones; it is modified according to the general plan of the whole, of which they are the parts; thus the different uses of the carpus, metacarpus and vertebral column determine the different forms of their respective bones. These bones have always many cavities and eminences upon their external surfaces, necessary for their numerous articulations, for the insertion of the many ligamentary cords that unite them, and the muscles that move them.

In the interior, these bones have nothing peculiar, except an abundance of the texture of the cells which forms them almost wholly, and exposes them to frequent caries.

Nature is not however regular in the division of bones into long, flat and short. Here as elsewhere, she disregards our methodical descriptions, and shows us the bones sometimes exhibiting the character of long ones and short, and sometimes uniting the attributes of both these last with the flat ones. The basilary apophysis and the superior part of the occiput, the body and the lateral portions of the sphenoid, when placed in contrast, prove this assertion. A bone sometimes by its external form belongs to the long ones, but from its internal organization should be classed with the flat, of this the ribs are an example, &c.

IV. Of the Bony Eminences.

The bony eminences have generally the name of apophyses; they are called epiphyses when the cartilage of ossification which unites them to the bone is not yet encrusted with calcareous substance.

These eminences have four great divisions; viz. those, 1st, of articulation; 2d, of insertion; 3d, of reflection; 4th, of impression.

1st. The eminences of articulation vary according as the articulation is moveable or immoveable; I shall not consider them here, as I should be obliged to repeat it in the chapter upon articulations.

2d. The eminences of insertion are very numerous in the bones; they only give attachment to the fibrous organs, as the ligaments, the tendons, the aponeuroses, the dura-mater; no organ differing from these is implanted into the bony eminences, or generally into the bones, except by means of them; the muscles are a remarkable example of this.

These eminences are usually much less in women than in men, in children than in adults, in weak animals than in carnivorous ones who live by attacking and destroying their prey. The prominence of the eminences of insertion is always an index of the force and vigour of the motions. They are the more developed in proportion as the muscles are. Examine comparatively the skeleton of a strong, sanguineous man, whose muscles are powerfully delineated through the integuments, and that of a feeble, phlegmatic man, whose rounded forms like those of women, do not appear prominent, and you will see the difference.

The form of these eminences of insertion varies greatly; sometimes the muscles are inserted by many separate aponeurotic fibres; then they are small, very numerous and form only little asperities imprinted on a greater or less surface; sometimes it is by a single tendon that the muscle takes its origin, then the apophysis is usually very prominent, and occupies a small space. Sometimes a broad aponeurosis gives rise to the fleshy fibres; it is then a bony line, more or less projecting that gives insertion.

The eminences are in general in proportion to the muscles that are attached to them; for example, in three muscles of nearly equal size, one of which is attached by separate fibres, the other by a tendon, and the other by an aponeurosis, we observe that the sum of the asperities of insertion of the first, the separate apophysis of the second, and the prominent line of the third are nearly equal in the quantity of osseous substance that forms them; so that by supposing that the apophysis was divided into asperities, or extended into a line, or that the asperities were united together, or the line concentrated so as to form an apophysis, this quantity of osseous substance would be found to be about the same.

We understand all the advantage of the eminences for the insertion of muscles, which they render distant from the centre of the bone, lessen the parallelism with its axis and consequently favour their motions in an evident manner.

Are these produced by the pulling of the muscles? This opinion borrowed from the laws of the formation of soft and inorganic bodies, does not accord with the known phenomena of vitality, with the existence of eminences where there is no muscular insertion, and which are often more prominent than these, with the disproportion that exists between the elongation of certain apophyses by muscular insertion, that of the styloid, for example, and the force of the muscles that are attached to it, &c.

The eminences for ligamentary insertion have the advantage, by removing a little the ligament from the articulation, of facilitating its motions; this is especially remarkable in the lateral ligaments of the elbow, the knee, &c.

As to the other eminences of insertion, we can hardly consider in a general manner their respective functions.

3d. The eminences of reflection are those under which a tendon passes, in deviating from its primitive course; such is the hook of the pterygoid apophysis, the malleolar extremity of the fibula, &c. Almost all these eminences have a slope or excavation in one direction, connected in the opposite with a ligament, so as to form a ring for the passage of the tendon.

4th. The eminences of impression are those which arise, when the different organs form on the osseous surfaces excavations that separate these eminences, which in fact only appear because the bone at this place remains at its ordinary level. The cerebral and muscular impressions are given as examples of this arrangement. But are these impressions really the effect of the compression of the organs on the bone, or do they arise from the laws of the osseous development, laws which give to the bones forms accommodated to the surrounding organs? I adopt more readily the second than the first of these opinions, which has been thought very probable from the effect of aneurisms upon bones that are contiguous to them, which are worn and gradually destroyed by them. But let us remark that if the muscles, the brain, and the vessels by their pressure, had upon the bones in a natural state, an action analogous to that of aneurism, the state of the parts ought to be the same as in that case. The compact layer ought to be destroyed where these depressions are, and leave in its place an unequal, ragged surface, but the contrary happens, which makes me think, that what is commonly called the impression of organs, is only a natural effect of ossification.

V. Of the Osseous Cavities.

The osseous cavities are very numerous; those only which are found on the exterior of the bones will be treated of. They are divided, like the eminences, into articular and non-articular. The first will be examined, with the analogous eminences, in the chapter on articulations. Among the second there are cavities, 1st, of insertion; 2d, of reception; 3d, of slipping; 4th, of impression; 5th, of transmission; 6th, of nutrition.

1st. The cavities of insertion give attachment to the aponeuroses of the muscles, to the ligaments, &c. They have the advantage, 1st, of multiplying the insertions of the fibres, without increasing the size of the bone, since a concave surface is evidently more extensive than a plain surface would be which should occupy the space between its edges; 2d, of allowing the muscular fibres more room, and consequently giving them greater length than if they arose from an eminence, which also gives more extent to the motions. The pterygoid, digastric cavities, &c. present examples of this arrangement.

2d. The cavities of reception are those which serve to receive an organ, lodge and defend it; such are the fossÆ of the bones of the cranium, those of the ossa ilii, &c. These cavities sometimes belong to the whole of the bone, the form of which is concave, as we see in the frontal bone, sometimes they are hollowed out upon an insulated part, like the maxillary depression of the inferior jaw; they are always destined for an essential part, for a gland, a viscus, &c.

3d. The cavities of slipping are in general found at the extremity of the long bones. They are grooves, more or less deep, in which the tendons glide to go to the place in which they are inserted. All are covered with a cartilage and terminated by a very strong ligamentary ring. Do the tendons by their friction form these cavities? This is the common opinion, but it does not appear to me more probable than the theory of muscular, vascular impressions, &c. These cavities ought to be then so much the deeper, in proportion as the muscles are the more exerted; they ought not to exist in subjects paralytic from their infancy; they ought not to exist in the cartilages of ossification in the foetus, whose limbs have hardly ever moved; but the contrary of all this is constantly observed. Let us describe then all the different configurations of the bones, as a consequence of the laws of ossification, laws in obedience to which the osseous forms, all primitively determined, are made to develop. The size of the extremities of the long bones favours the existence of these different cavities, which cannot on this account injure the osseous solidity.

4th. The cavities of impression correspond with the eminences of the same name. I have spoken of them above.

5th. The cavities of transmission are especially destined for the vessels and the nerves. We find many of them on the head; they have sometimes the form of a groove, sometimes that of a tube and at others that of a slit, according to the thickness or breadth of the bones which these vessels or nerves traverse in order to go from one place to another. The periosteum lines them; they contain more or less cellular texture. The nerves and vessels they transmit are foreign to the bones.

6th. The cavities of nutrition, on the contrary, give passage to vessels which carry to the bones or the medullary organ the substances that repair them. They are of three sorts.

The first form canals that are seen on the long bones exclusively, and go to the medullary cavity. Each bone has but one of these, situated always on its body, directed obliquely between the fibres of the compact texture, running sometimes from below upwards, sometimes from above down into the cavity of the bone, and thus forming a communication from without to within for the vessel of the medullary organ. This foramen serves particularly for the exhalation and nutrition of this organ, and nourishes the bone only secondarily.

The second kind of cavities of nutrition belong especially to the texture of the cells of the bones. Thus they are seen wherever this texture abounds, in the extremities of the long bones, the circumference of the flat ones, and the whole superficies of the short ones. Their diameter is greater than that of the canal which goes to the medullary cavity; it is less than that of the canals of the compact texture. Their number is very considerable; I have counted a hundred and forty upon the tibial extremity of the femur, twenty upon the body of one of the dorsal vertebrÆ, fifty upon the os calcis, &c. In general this number is always in proportion to the quantity of the texture of the cells that the bone contains. Hence why there are but few on the flat bones of the cranium, why they are more numerous on the flat bones of the pelvis especially where this texture is abundant, as on the ischium, on the iliac portion of the circumference of the ilium, &c. By pouring mercury into the spongy texture, it runs out from all these foramina, and thus proves their communications. They are irregularly scattered wherever they are. They are not met with on the body of the long bones, because the body contains little or none of the texture of the cells.

The third kind of canals of nutrition is only destined to the compact texture. It consists of an infinite number of little pores which the eye can clearly distinguish, and through which small vessels pass, that go to this texture. An evident proof that they do not go to the texture of the cells, is, that in the preceding experiment, the mercury never finds in them a way to escape externally. It is impossible to determine their number; it is prodigious in childhood. As the bones in old age become filled with calcareous substance, they are obliterated, and the vessels they contain become small ligaments, foreign to osseous nutrition, which continually grows weaker, and is soon annihilated, and allows necrosis to seize upon the bones, if general death does not prevent this partial death of the osseous system.

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ARTICLE SECOND.
ORGANIZATION OF THE OSSEOUS SYSTEM.

The peculiar texture of the osseous system forms in it the principal and predominant part, especially as we advance in age. The common organs are in much less proportion.

I. Texture Peculiar to the Osseous System.

The texture of the bones, like that of most of the other organs, presents itself under the aspect of fibres whose nature is everywhere the same, but which differently arranged, form two principal modifications; in the one, these fibres being more or less scattered, exhibit many cells; in the other being close to each other, they form a compact substance in which it is difficult to distinguish them. Hence two sub-divisions of the osseous texture, that with cells, and the compact. Authors admit a third one, the reticular; but this is included in the first.

Texture with Cells.

The texture with cells does not exist in the first periods of ossification. The time of its formation is when the phosphate of lime is added to the gelatine of the primitive cartilage, and gives to the organ the bony nature. Then an infinite number of cells is formed in the solid mass of cartilage, because the gelatine, taken up by the absorbents, disappears in the place they occupy. No more is brought by the exhalants, which begin to carry the phosphate of lime to the fibrous cross-pieces, whose interlacing forms these cells; so that the development of the texture of the cells belongs evidently to the disproportion that takes place in the bones at a certain period of their growth, between the functions of the exhalant and absorbent system, until then in equilibrium. We know not the cause of this disproportion, it appears to be a law of ossification. It is by virtue of this law and by an analogous mechanism, that the os ethmoides, at first solid and full when it is cartilage, is hollowed out at the period of its ossification, into a great number of cells. It is thus that the sphenoidal, frontal sinuses, &c. are formed and enlarged.

The formation of the texture of the cells ceases when all the epiphyses have disappeared. At this period it exhibits to us an infinite number of fibres which appear to arise from the internal surface of the compact texture, go in different directions, cross, unite, separate, bifurcate, in a word, pursue such irregular courses, that it is impossible to follow them. Their size is not less variable; sometimes their delicacy is such, that they can hardly be touched without breaking; at others they are quite large. Often instead of fibres there are layers, of more or less considerable size, from which arise other smaller ones, which appear to ramify, and from which result, when they are near each other, species of canals, which are seen very well by sawing transversely the extremity of a long bone, so as to have a segment of half an inch.

The cells which are made by their separation, are of very unequal form and capacity.

All communicate together; the following experiments prove this. 1st. If we make a hole in the extremity of a long bone, or upon the surface of a short or flat one, and pour in mercury, it passes through all the communications, and comes out of the natural foramina on the surface of the bone, which also open into the cells. 2d. Saw a long bone at one of its extremities, cover its whole surface with something that shuts up its pores, then expose it to the sun; the medullary fluid not being able to escape by the external pores, will come out at the sawed place, after passing successively through all the cells. 3d. By varnishing a dry bone, and opening it only in two opposite points, we can force air, water and every kind of fluid through these communications, from one opening to the other.

We can then consider the interior of every bone as forming a general cavity that is filled by many interlaced fibres. I have not observed a sensible difference in the direction of these fibres in the three kinds of bones.

Compact Texture.

The fibres that form the compact texture are not the same as those of the preceding. These fibres, being in juxta-position, not leaving any space between them, giving by their approximation a remarkable density to the texture they form, have a longitudinal direction in the long bones, are in the form of rays in the flat ones, and cross each other in all directions in the short ones. This triple arrangement of the fibres of the compact texture appears to be wholly owing to the manner of ossification. In fact, when we examine its progress in the primitive cartilages, we see these organs encrusted with the phosphate of lime, in the same direction which these fibres afterwards take. Thus these fibres are very evident in the first age, on the bones of the cranium in particular. When the phosphate of lime, successively deposited on the cartilaginous parenchyma, predominates there, then the whole is confounded in the compact texture in one homogeneous mass. But still there are different circumstances that indicate the primitive direction of the fibres: 1st. When by an acid we remove from bones their calcareous part, then the cartilaginous portion keeps as a kind of mould, the form of the substances that filled it, and exhibits fibres whose direction is the same as that pointed out for the three species of bones. If we wish to separate the cartilaginous layers, it is in this direction that it is most easily done. 2d. The fissures that come in bones long exposed to the air follow in general the natural direction of the fibres. 3d. Calcined bones exhibit nearly the same phenomenon.

The direction of the fibres of the compact texture is changed entirely in the apophyses, in which it does not follow that of the principal bone. In those, which by their form, partake of the character of the long bones, as in the styloid, these fibres are longitudinal; they go in all directions in those, which like the mastoid, the different species of condyles, &c. resemble in their shape the short bones.

The assemblage of the fibres forms, according to anatomists, layers which they have considered as in juxta-position, and held together by little pins according to some, and by the interlacing of fibres according to others. These osseous layers do not appear to me to exist in nature. All the fibres of the compact texture adhere to each other, cross and form a whole that we cannot conceive of in this manner, and which besides does not accord with the irregularity of the distribution of the vessels. Art separates here fibres layer by layer, as it is done in a muscle, in a ligament, &c.; but these layers are wholly factitious; to exhibit the bones as formed by an union of these layers is to give a very inaccurate idea of their structure. It is still more inaccurate to consider these layers as attached to each other by osseous pins, by attraction, or by a glutinous matter which serves as a glue. All these ideas, contrary to anatomical examination, suggested by a false application of the laws of the adhesion of inorganic bodies to the adhesion of organized fibres, now belong only to the history of physiological errors. There is a circumstance, it is said, that very evidently proves the lamellated structure of the bones, it is their exfoliation. It is true that often very distinct layers are separated from the living bone, but these layers are only the product of exfoliation itself. Then in fact the bone dies on the surface; the superficial vessels receive no more blood; this fluid is stopped under the portion deprived of life, the exhalation of the phosphate of lime ceases there, every kind of sanguineous, exhalant and absorbent vessel is destroyed; a slow inflammation, with suppuration, comes on, and fixes the line of demarcation; and as this line is often at the same place, all which is above it becomes an inorganic layer which gradually falls off, and preserves its osseous solidity, because the dead absorbents were not able to remove the phosphate of lime. Besides, nothing is more common than to see exfoliation take place not by layers, and the bone afterwards exhibit an unequal surface, the effect of the inequality of the thickness of the exfoliated portions. Finally, exfoliation often takes place in a direction opposite to that which the layers are thought to have; this is what we see in the separation of the extremity of the long bones, that have been exposed to the air or too much irritated after amputation, in the shedding of the horns of animals, &c. Let us consider the compact texture as an assemblage of condensed fibres, not separated by layers, which we can only consider as imaginary.

The fibres of the compact texture differ in their organic arrangement, from the muscular fibres in this, that frequent elongations unite them to each other, whereas the muscular have only the cellular organ, the vessels and the nerves as the means of union. Such is the intimate juxta-position of the fibres of the compact texture, that they leave between them only pores hardly sensible to the naked eye, but which become so however with a glass, and which the medullary juice and vessels fill. In the rickets this density of texture disappears, and we observe in the middle part of the long bones and under the layer of periosteum more thick than common, an osseous texture, easily bent in all directions, forming an infinity of cells and taking the place of the compact texture that ought to be there. It appears that this change of compact texture into that of cells is made less by the absorption of a part of the phosphate of lime, than by the extension of the osseous fibres which separate from each other, and leave between them spaces that did not before exist; this gives to the bodies of long rickety bones a very considerable thickness. I have many times made this remark.

Arrangement of the two Osseous Textures in the three kinds of Bones.

The osseous textures, considered in the different kinds of bones, are differently arranged. In general the compact forms the exterior, the covering of the bone, and that of the cells occupies the interior. The ossa spongiosa form an exception to this rule, the modifications of which we shall now examine.

1st. In the long bones, the compact texture has a very remarkable thickness in the centre, where it serves the triple purpose, first of protecting the medullary organ, of which it is the covering, then of giving solidity to the bone in this place, which more than the extremities, is exposed to great efforts in locomotion, falls, concussion, &c. and where the bone, traversed only by some very weak fibres of the cells, cannot borrow its resistance but from its external parietes; finally, of thus diminishing without danger the size of the bone in the middle part of the limb, the form of which, becomes by this means much more regular. So that as we go from the centre, we see in a long bone, sawed longitudinally, the compact texture diminish in thickness, and form at last at the extremities only a delicate layer analogous to that which covers the short bones. Thus the power of resistance of the long bones, at their extremity, is less in their compact shell, than in the great quantity of the texture of the cells deposited under it; it is this especially that prevents fractures; hence we see how the proportion of the compact texture and that of the cells being inverse in the two parts of the bone, the manner of their resistance is also inverse.

The texture of the cells differs a little when examined in the medullary canal and in the extremities. In the canal there are extremely delicate filaments, continued from larger fibres which fill above and below the extremities of the bone, and the compact portion which forms the osseous cylinder. Few and scattered at random in the middle of the canal, these filaments approximate each other, and form a kind of net-work, as they go from it; hence the name of reticular substance by which it is designated. But it is not a distinct texture, it is only a modification of that of the cells; a modification, which is especially characterized, 1st, by the delicacy of the fibres; 2d, by the uniform absence of those fine and short layers which frequently belong to this texture in other parts. Besides, the manifest use of this portion of the texture of the cells, too weak to contribute to the resistance of the bone, is evidently to serve as a support to the medullary system, and insertion for its membrane. At the extremities of the long bones, the fibres of the texture of the cells increase a little, approximate each other, are scattered in layers, and give to the bone by their union and number, a remarkable thickness and resistance, without however increasing the weight, which very much favours locomotion, considering that this weight placed at the extremity of the lever would have been very painful to raise.

2d. In the flat bones, the compact texture forms two external layers, the thickness of which is between that of the middle of the long bones, and that of the extremity of the same bones, or that of the short ones. Between these two layers is found the texture of the cells, similar in general to that of the extremity of the long bones, a little more lamellated however, thicker usually at the circumference, often almost wanting in the middle of the bone, where its two compact layers in juxta-position allow a light to be seen through it, when placed behind. In general wherever the broad bones are so thin, from the want of the texture of the cells, there are very strong muscles, which by their thick layers give solidity to the bone. We see examples of this in the iliac, sub-scapular, inferior-occipital fossÆ, &c.

3d. In the short bones, the texture of the cells always predominates; the bone is almost wholly formed of it, a delicate layer of compact texture forms only its covering, and in this respect, the organization of these bones is the same as that of the long bones at their extremities; thus the resistance of the bone depends on the whole of its mass, and no part makes a greater resistance than another against fractures. We see, from all that has thus far been said, the successive manner of the solidity of the different bones. In the middle of the long bones, there is hardly any thing but compact texture to which it is owing; in the flat bones it is as much to this texture as to that of the cells; in the extremities of the long bones and in the short ones it is almost to this last only that its solidity is owing.

4th. In the osseous eminences, the compact texture is more abundant than elsewhere, especially in those of insertion, as in the prominent lines of the long bones, which are all formed of it, in the asperities of the osseous surfaces, in their angles. If the eminence is considerable, there enters into it also more or less of the texture of the cells as we see in the spinous and transverse processes of the vertebrÆ, in the coracoid, mastoid, &c. processes. The eminences of the moveable articulations have in general less of the compact texture, solidity is given to the bone by the articular cartilage. Those of the immoveable articulations, on the contrary, in general smaller, as the sutures of the bones of the cranium, for example, are in proportion more compact than cellular.

5th. In the osseous cavities, all those which serve for moveable articulations, are only furnished with a very delicate compact layer; it is thicker when the articulations are immoveable. In general all the foramina, cavities and canals that transmit from one region to another vessels, nerves or other organs are everywhere lined with a compact layer that defends them from the impression of these parts. The foramina at the base of the cranium, the dental canals, the vidian foramina, &c. are examples of this arrangement.

Of the Composition of the Osseous Texture.

Whatever may be the modifications under which it is exhibited, the osseous texture has everywhere the same nature; the same elements form it; now these substances are especially a saline calcareous substance and a gelatinous one.

The existence of the saline substance in the bones is proved in different ways. 1st. Combustion, by destroying the gelatinous portion, leaves a friable, brittle body, of a form analogous to that of the bone and which is nothing but this saline substance, which resembles, if we may so say, a moulded body that keeps the form of the mould after it has been taken away. If the combustion is pushed very far, and a red heat produced on the calcined bones, they undergo a semi-fusion, which makes them resemble the state of porcelain; they have then a very compact, fine, semi-vitreous grain, a semi-transparency, and an appearance like that of the vitrified earths. 2d. The long continued exposure of the bones to the air produces an effect very similar to that of the first degree of combustion, though however the gelatine is rarely so thoroughly removed, and the saline portion so perfectly exposed as by the action of fire. Besides, it requires a very long time to produce this effect, especially upon the thick bones; the thin ones are more easily altered; I have often made this observation. After ten years exposure to the air and rain, I have observed that clavicles taken from the cemetery of Clamart, exhibited upon the action of the acids, a cartilaginous parenchyma almost equal to that of a bone that had been some time dried. But this parenchyma finally disappears, and the bone falls to powder, when it is no longer supported by it, and the particles of the remaining calcareous substance have been disunited by time. 3d. In the last stages of all cancerous diseases, the bones have a friability which is only owing to the greater proportion of this last substance, a proportion arising itself from the small quantity of gelatine that is then exhaled in the bones. 4th. When a bone has been for some time exposed to the action of an acid, the nitric for example, a portion of its substance is taken from it by this acid, which is evidently a calcareous salt, as can be seen by mixing it with a solution of an alkali, which uniting immediately to the acid, exposes this salt, by making it precipitate. 5th. Papins digester, by dissolving by the action of water reduced to vapour the gelatinous portion, shows also this saline calcareous part.

Scheele has found that this portion is a neutral salt with an earthy base, the phosphate of lime. Frequently the phosphorus in fresh bones give them a luminous appearance, that can be seen very far in the night. It is sometimes the whole of the bone, sometimes some parts only that become luminous. I have always observed in the illuminated places an oily exudation, either that comes from the medullary juice, or is furnished by the fat of the neighbouring soft parts of the bone.

Different facts as evident as the preceding, prove in a manner not less certain, the existence of a gelatinous substance in the bones. 1st. When in the solution of the bones in the acids, the phosphate of lime has left them, there remains a cartilaginous, flexible, elastic body, yellowish when nitric acid is employed, of the same form as the bone. Now we know that the gelatine especially nourishes the cartilages. 2d. If besides we subject this cartilaginous residue to ebullition, we extract a very great quantity of gelatine which is dissolved in the water and can be afterwards precipitated by tannin. This substance can even be removed from the bones without the previous extraction of the phosphate of lime; it is thus that with bones stripped of every surrounding organ, and reduced to very small fragments or even to powder by the action of a rasp, very nourishing broths and jellies are made. It is not without reason that in the preparation of boiled meat, the bone is left attached to the meat; besides the white organs that surround it, and the medullary oil that it contains, it furnishes to the broth a substance that is peculiar to it. 3d. The combustion of the bones, and especially of their cartilaginous residue, gives an odour exactly similar to that of the combustion of the different animal glues, which, as we know, the gelatine especially forms. 4th. In the different affections in which the bones become soft, the earthy substance is diminished more or less sensibly, and the gelatinous remains more abundant in proportion than common.

These two substances, the gelatinous and saline, which enter essentially into the composition of the bones, imprint upon them very different characters. The phosphate of lime, almost foreign to vitality, is only destined to give to the bones the solidity and resistance that characterize them. The gelatinous substance, on the contrary, has especially the animal character; thus the vital activity is in the inverse ratio of one and the direct ratio of the other, as we shall see. Deprived of gelatine, the bones are not capable of being digested, they offer nothing for the gastric juices to act upon, they cannot extract nutritive matter from them, because they act upon them nearly as water does, which dissolves the gelatinous substance and extracts it from the saline portion. Different animals that swallow fresh bones for nourishment, would die from eating a calcined one; thus the more the bones contain of this substance, the more nourishing they are; those of young animals are on this account more proper to make gelatinous broths, more suitable to be digested raw by the stomachs of certain species, &c. If we expose a bone to the action of an acid, so as to have only its cartilaginous parenchyma left, and afterwards soften this parenchyma in boiling water, it becomes an aliment that can be eaten.

Besides phosphate of lime and gelatine, the bones contain also some saline principles, as the sulphate and carbonate of soda, &c. But this proportion is too small to be noticed. Upon this point, I refer to chemical books, especially to the great work of Fourcroy.

II. Common Parts which enter into the organization of the Osseous System.

The ancients ranked the bones among the white parts, among the tendons, the cartilages, &c. It is sufficient however to examine the interior of them to see, by the redness that distinguishes them, that much blood enters them. This blood penetrates in three orders of vessels; one belonging to the medullary cavity of the long bones, another to the texture of the cells, and the other to the compact texture. These two last orders distributed in the osseous texture, appear to be especially destined to deposit the phosphate of lime; for in the cartilages of ossification, the white vessels alone carry the gelatine; in other cartilages it is the same; so that I think that this kind of vessels is also destined in the bones which are perfectly formed to nourish their cartilaginous parenchyma, whilst the red vessels belong more to their calcareous portion.

Each medullary cavity has only one vessel, and only one foramen of nutrition. This vessel has a diameter proportioned to that of the bone which it penetrates, and in which it is divided immediately into two branches, without permitting any ramification on the compact texture. These go in an opposite direction to the two extremities of the bone, ramify ad infinitum in the medullary organ, and their last branches are lost in the commencement of the texture of the cells, where they anastomose with the vessels of this texture; that which occupies the medullary cavity under the name of reticular, and the internal surface of the compact texture, receive also some branches. A vein everywhere accompanies the artery, and follows the different distributions of it.

The vessels of the second order belong to the texture of the cells of the long, flat and short bones; they are equal in number to the foramina of this texture, and ramify on its cells; they communicate with those of the marrow and of the compact texture. At death, the small arteries in general remain full of red blood, which indicates their course which their minuteness would conceal, and which injections can rarely demonstrate with accuracy. The accompanying veins of these arteries can hardly be seen.

The blood-vessels of the third order are only the last ramifications of the arteries surrounding the bones, ramifications which enter in great number the compact texture, and stop there. The existence of these vessels may be proved in different ways. 1st. By detaching the dura mater from the internal surface of the cranium, many small sanguineous drops prove their rupture. 2d. By raising on a subject of a middle age the periosteum, we make the same observation. I have remarked that these experiments succeed especially on those that have been drowned, or on animals destroyed by asphyxia, on account of the great quantity of blood their vessels contain. 3d. If we fracture a long bone in the middle, the compact portion, which forms the medullary canal, exhibits small reddish striÆ, which are nothing but these small vessels still full of blood, and of which we thus discover a greater or less number, according to the manner in which the blood was arrested in the capillary system at the instant of death. 4th. The saw-dust of the compact texture in living animals is red, though less evidently so than that of the texture of the cells; a proof that these vessels have been divided.

The vessels of the bones are very numerous in childhood; they diminish in the adult, and become scarce in old age. The facility of the formation of callus follows the same proportion in the different ages of life. Often in affections of the osseous parenchyma they have a remarkable development, which much exceeds their natural diameter. Osteo-sarcoma, spina-ventosa, &c. exhibit this, which is much oftener observed in cancerous tumours than any other.

These vessels communicate with each other by numerous anastomoses; this is what we see especially in the long bones, between those of the medullary organ and those of the texture of the cells. By these communications, they mutually assist each other's functions. I have seen the nourishing foramen of the tibia completely obliterated in a body that I injected. A sort of cartilage filled this foramen; the artery formed a real ligament. Yet its bifurcation in the medullary canal was found very well injected, and besides no alteration appeared in the nutrition of the medullary organ, which had probably received as much blood as usual. I found nothing in the neighbourhood of the foramen, which showed the cause of this obliteration, which an exostosis, an affection of the periosteum, or an inflammation can very easily produce.

On the other hand we know that very considerable osseous layers are often taken from the extremity of the long bones by caries, which consequently destroys all the vessels corresponding to these layers, and yet the bone beneath lives, principally by the blood that it receives by the extremities of the artery of the medullary organ. This is nearly what happens to the long bones in the first age, in which the cartilaginous extremities have not vessels of the second order, and in which consequently almost all the blood comes from this same artery of the medullary organ; thus it is much larger in proportion, and the foramen which receives it much more considerable.

Nothing is yet known upon the systems of absorbent and exhalant vessels of the bones, and we can reason upon this point only from analogy. Besides the nutritive process evidently supposes them there.

As to their cellular texture, it appears to be almost nothing; we can even say that in whatever place we break the compact fibres or those of the cells, its filaments are not distinct; but it is their dense and compact texture that conceals them from us. In fact, 1st, when this texture is softened, and the bone has become flesh, as it is called, the cellular texture is very apparent there. 2d. The fleshy granulations, rising on places that have been fractured or laid bare, are only the extension of the cellular texture which has too much calcareous substance to allow it to be seen in the natural state. 3d. After having removed from a fresh bone all this substance by an acid, I have sometimes observed cellular filaments by separating the cartilaginous fibres which form the parenchyma that is left. 4th. When we boil this cartilaginous parenchyma in order to extract the gelatine from it, there remains portions of membranes which are evidently cellular.

We cannot trace the nerves in the bones, the filaments that enter them are so fine; I do not know that anatomy has any positive data upon this point.

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ARTICLE THIRD.
PROPERTIES OF THE OSSEOUS SYSTEM.

I. Physical Properties.

The bones have very strongly marked physical properties. Solidity and hardness are their peculiar portion; they derive these properties from the phosphate of lime which penetrates them, thus they are constantly increasing with age, because this substance becomes more and more predominant. Elasticity is another physical property of the bones, which is found combined with the two preceding, but which is in an inverse order; as it is in the gelatinous substance, in the cartilaginous portion of the bone that it resides, it is, like this portion, greater in childhood. In old age, the bones lose entirely their suppleness and elasticity; they break more easily. Elasticity is more evident in the long and small bones, than in those which are larger; the fibula bends and evidently goes back again, this the tibia could not do without difficulty. It is not that the one is more elastic than the other, but it is that its conformation is more favourable to the development of this property.

II. Properties of Texture.

Although the hardness and solidity of the osseous texture seem to be opposed to every kind of extension and contraction, yet these two phenomena and the properties of texture from which they arise, are often very evident in it.

The extensibility of the osseous fibres is proved by the observation of many diseases, for example, the spina-ventosa, the swelling of the maxillary sinus when it contains a polypus, by the enlargement of the bones of the cranium in hydrocephalus, &c. I would remark on the subject of these different distensions, that often by the influence of analogous causes, the bones which yield and are distended in the above cases, are broken, worn and destroyed in others. A polypus of the nose breaks through the naso-palatine partition, without having first distended it; aneurism of the aorta does not bend the sternum or the vertebrÆ, but it breaks through and destroys these bones. Whence arises this difference from causes nearly the same? This is not easily determined. The contractility of texture is very evident in the bones, when the cause which distended the fibres is removed. We see the alveoli contract, and become effaced, when a tooth has been drawn from them. The diminution of the thickness of the jaw after cutting the teeth arises only from the contraction of its fibres, which are no longer distended as much, because the root is not so broad as the crown, which had till then been wholly in the bone. The maxillary sinus contracts when a fungus is removed from it, or pus is discharged from the carious bone, &c. If death was not too soon the consequence of the puncture of the head of hydrocephalic patients, I am persuaded that we should see the bones gradually contract, and restore the cavity of the cranium to its natural dimensions. When we remove the dead piece from a long bone in necrosis, the new bone, formed on the exterior by means of the periosteum contracts in an evident manner. In paralysis of the optic nerve, its foramen becomes narrower. The orbit contracts when a cancerous eye has been extirpated. I have dissected the carotid canal in a dog whose carotid I had tied; there was no contraction because the blood coming by anastomoses dilated the artery to the usual size.

This contraction of the bones, by means of the contractility of texture, is not so sudden as that of the muscles, the skin, &c. when they are no longer distended by a tumour, an aqueous collection, &c. This arises from the difference of the organic texture, from the rigidity of osseous fibres owing to the calcareous substance they contain, &c. Thus the organic sensibility is less evident in them.

III. Vital Properties.

The bones have hardly any animal properties in a natural state. Their sensibility is nothing; the saw, the mallet, and the chisel act upon their texture almost with impunity; an obscure feeling is the only result of the action of these instruments; fire even can act upon them without making the animal suffer much. But in a morbid state, the sensibility is developed to the greatest extent; we know the horrible pains that attend spina-ventosa, and those not less severe that caries produces in certain cases. If a bone is inflamed, as for example the sawed extremity of a stump after amputation, this bone which in a natural state had borne, without transmitting any painful impression, the action of the saw, becomes as it were a new sensitive organ, to which the least touch is painful. The animal contractility is nothing in the osseous system.

The organic properties give life to this system as to all the others. The sensibility of this kind certainly exists in it; the fluids that penetrate it are felt, and by virtue of this feeling, those are appropriated to it which are proper for its nutrition. But is there in the osseous system a reaction upon these fluids? are there those insensible oscillations which compose insensible organic contractility? Its hardness seems to prevent them. But yet the circulation is carried on there; it performs a constant work, an habitual composition and decomposition, which can hardly be conceived of without reaction on the part of the osseous system. Besides this reaction is more slow, more difficult on account of its structure; and hence without doubt the slowness, of which we shall speak, in the vital phenomena of the osseous system. Sensible organic contractility is foreign to it.

Character of the Vital Properties.

The peculiar life of the bones is composed then of only two vital properties, organic sensibility and insensible organic contractility. From these two properties are derived all the vital phenomena that these organs exhibit, inflammations, formation of tumours, cicatrization of solutions of continuity, &c. This peculiar life is remarkable in general, as I have just observed, when compared with the peculiar lives of the other organs, by its slowness, by the tardy concatenation of its phenomena. All things being equal as to ages, and the different proportions of the earthy and cartilaginous substances, inflammation is more slow there than in the other parts. Callus is remarkable among the other cicatrices by the length of its formation; compare an exostosis in its origin, its progress and its development, with a tumour of the soft parts, a phlegmon for example, and you will see the difference. Who does not know, that whilst suppuration often requires only a few days in the other organs, it is whole months in forming in the middle of the bones? Observe the difference that there is between a gangrene of the soft parts, in which death takes place in a short time, with caries and necrosis of the bones, in which a long period elapses between disease and death of the part. In general we can say, when inflammation exists in a bone, that it is chronic.

Sympathies.

This character of the vital properties imprints an analogous one upon the sympathetic relations of the osseous system with the other systems. At first the animal contractility and the sensible organic contractility cannot be put in action in these relations, as they do not exist in the bones. The animal sensibility being developed in them with difficulty and slowly by the diseases that essentially affect them, the sympathies can be brought into action in them only in an obscure manner. These sympathies then should act essentially upon the organic sensibility and upon the insensible organic contractility, and as these two properties are developed slowly, the different sympathies should not be connected with the acute affections of the other organs, and this is what is clearly proved by observation. In fact observe that whilst many other systems respond with great quickness to the acute diseases of an organ, this, as well as the cartilaginous, fibro-cartilaginous systems, &c. remain then almost always in inaction. Let the stomach, the lungs, the brain, &c. be the seat of a severe acute disease, you see immediately many sympathetic phenomena arise in the nervous, vascular, muscular, glandular, cutaneous, mucous systems, &c. &c.; all seem to feel the trouble of the affected organ; each, according to the vital forces that predominate there, exhibit different phenomena, which are only aberrations, irregular developments of these forces; in the animal muscular system, it is the animal contractility which is especially raised; hence spasms and convulsions; in the glandular, the serous, the cutaneous, the mucous, &c. the insensible organic contractility and the organic sensibility principally experience alterations; hence the different sympathetic derangements of the secretions, of the sweat, of the exhalations; in the nervous, it is the animal sensibility which is especially brought sympathetically into action; hence the wandering or fixed pains in different parts; in the organic muscular, it is the organic contractility which is raised; hence the irregular motions of the heart, the stomach and the intestines. In all the acute diseases of an organ there are always two orders of symptoms, the one relative to the affected organ, as are the cough, the pain in the side, the spitting of blood, the difficulty of respiration, &c. in peripneumonia; the others purely sympathetic and arising from the relations which connect the vitality of this organ with that of all the others; now these last are often much more numerous than the others.

Observe the bones in the midst of all that general sympathetic derangement of the systems in which life is very active; they undergo no alteration; their life, more slow than that of the other systems, is not connected with these phenomena which have an acute character; neither is that of the cartilages, the fibro-cartilages, the hair, the aponeuroses, &c. All these systems, remarkable by the same character of vitality, do not respond to the acute affections of the other systems; they are not sympathetically affected, during these affections, at least in an evident manner. Observe all the acute fevers; their numerous phenomena have an effect only upon those systems in which life is very active; those in which it is distinguished by an opposite character, have uniformly no connexion with these phenomena; they are, if we may so say, calm and tranquil in the midst of the tempest which agitates the others. Let us take for example the different eruptions that appear in fevers; it is upon the skin, the mucous surfaces, &c. that they come; they arise during the fever and they disappear with it; now the bones, the cartilages, &c. could not, from their kind of life, admit of this sudden origin and disappearance.

It is then in the slow and chronic affections that we must seek for examples of sympathies of the osseous, cartilaginous systems, &c. In the first stages of the venereal disease, in which it is marked only by acute symptoms, or in which at least its progress is not very slow, as when it appears in buboes, in inflammations of the urethra, &c. it has no influence upon the osseous system; it is only when it is of long standing, when it has, as it were, degenerated, and become chronic, that it makes the bones the seat of pains, of different tumours, &c. Besides, I do not know, that we have yet thoroughly analyzed the osseous sympathies. I have shown only their general character. We shall understand them better, when we have given more attention to the relation that there is in diseases between the affection of each organ, and its kind of vitality.

Seat of the Vital Properties.

The bones penetrated by saline substances which tend continually to obey the laws of affinity and attraction, and to make these laws predominate over those of sensibility and organic mobility, seem to hold a middle place in living bodies, between these bodies and inanimate ones. There is truly but one part of their osseous texture which partakes of the vital phenomena, viz. their cartilaginous substance; the other part or calcareous substance is foreign to them; thus the proportion of each of these substances determines in the bones their degree of life. In infancy, in which the first predominates, in the early stages of the formation of callus, in which it is exclusively found, in the softening of the bones in which it remains almost alone, all the vital phenomena become more evident and more powerful. On the contrary, as age accumulates in the bones the saline substance, as in certain animals this accumulation takes place by the natural laws of ossification in some external portions of the system with calcareous base, as in the horns of stags, the shells of crustaceous animals, &c. so life is, if we may so say, successively destroyed in the bones; it becomes nothing, when this calcareous portion predominates considerably; this is what happens in the necrosis which produces the fall of the horns, the casting of the shells of crustaceous animals, &c.

Besides, that which shows the vital energy in an organ, is the rapidity with which inflammation goes through its periods in it, and the frequency of this affection, &c. Now in the bones inflammation is so much the more rapid, in proportion to the greater quantity of cartilaginous texture they contain; observe the periods of the formation of the callus in the different ages, periods which are determined by the duration of the inflammation necessary for its formation, you will see that in infancy they are short, that they are much longer in old age, and that often even consolidation does not take place, whilst it is effected with facility in all the soft parts. The general weakness no doubt of all the vital forces which takes place from the effect of age is one cause of this slowness and this rapidity in the formation of the callus at the two extreme periods of life; but the different proportions of gelatinous and calcareous substances contribute much to it also; for when we compare other cicatrices with this, the cutaneous, for example, we see that age establishes in them an infinitely less sensible difference as it respects the slowness and rapidity of this reunion, than in the osseous system. The bones have not sufficient life to inflame and unite, like the skin, the muscles also exhibit this phenomenon in a very evident manner. I have seen an old man, the neck of whose fractured thigh-bone remained a long time without reunion, and in whom a wound of the face was healed very speedily by the first intention.

Finally, there is a simple experiment that I have often made, and which proves as well as the preceding facts, that the cartilage is truly the animal part of the bone. We know that one of the great attributes of animal substances, is to contract and exhibit the horny hardening when burnt; now when the bone is penetrated with its earthy salt, it has not this kind of combustion; deprived of this salt by an acid, the cartilaginous parenchyma which remains burns in this manner. The flat bones in infancy in which this parenchyma predominates, exhibits also this phenomenon in burning; it forces the calcareous portion, which is in small quantity to obey the impulse that it gives it, and turns it in various directions; but in the adult in whom the calcareous portion is the largest, the bone remains unmoved while the fire penetrates it, and its whole cartilage is taken away, without its fibres being able to obey their tendency to the horny hardening which combustion imprints upon them.

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All the bones are united together, and thus form the skeleton. The manner of their union varies, but whatever it may be, it is known under the general name of articulation.

I. Division of the Articulations.

All the articulations can be referred to two general classes. Mobility is the character of the first, immobility that of the second.

One belongs to all the bones which serve for locomotion, to some of those destined to internal functions, as the ribs, the lower jaw, &c. The other is especially met with in the bones, the union of which forms the cavities designed to defend the organs; this we see in the head, the pelvis, &c.

Moveable Articulations. Observations upon their Motions.

I divide moveable articulations into four kinds, the characters of which are borrowed from the different motions they execute. To understand this division, it is necessary previously to know the motions of the articulations in general. These motions can be included under four species, which are, 1st, opposition; 2d, circumduction; 3d, rotation; 4th, sliding.

1st. The motion of opposition is that which is made in two opposite directions, for example, from flexion to extension, from adduction to abduction, and vice versa. This motion is extensive or limited; extensive when it is made in all directions, first in the four named above, then in all the intermediate ones; limited, when it only takes place from flexion to extension, from adduction to abduction, &c. The thigh in its articulation with the pelvis enjoys an extensive motion of opposition. The tibia in its articulation with the femur has a limited motion of opposition.

2d. Circumduction is the motion in which the bone describes a kind of cone, the summit of which is in its superior articulation, and the base in the inferior; so that it is found successively in flexion, adduction, extension and abduction, or in abduction, extension, adduction and flexion, according to the motion by which it begins, and that moreover it goes through all the intermediate directions. Hence we see that circumduction is a motion composed of all those of opposition, and in which the bone, instead of moving from one direction to an opposite one, as in the preceding case, moves from one direction to another nearest to it, describing thus by its extremity a circle which is the base of a cone of which I have spoken, and which is so much the greater as the bone is so much the longer. We easily understand that among the bones, those only whose motion of opposition is loose, enjoy that of circumduction.

3d. Rotation is wholly different from the preceding motion. In this there was locomotion, a moving of the bone from one place to another; here it remains always in the same place; it only turns upon its axis. The humerus and the femur enjoy this motion which is simple.

4th. Sliding belongs to all the articulations. It is an obscure motion, by which two surfaces go in an opposite direction, by sliding as it were upon each other. In all the other motions, this is met with; but it often exists without them.

It is easy to understand, from these views upon the articular motions, the division into genera of the class of moveable articulations. In fact, there are articulations in which all the motions are united; in others, there is no rotation; in many rotation and circumduction are wanting, and opposition exists only in one direction; some have only rotation. Finally, there are those in which rotation, circumduction and opposition are nothing, and sliding alone remains.

Hence we see that nature moves here as elsewhere by gradation, that from the most moveable articulations to those that are the least so, there are different degrees of decrease, that she descends gradually to the immoveable articulations, that she is finally reduced to the motion of sliding alone, like that which exists at the carpus, the tarsus, &c. There is even an intermediate one between sliding and immobility; it is the articulation of the symphysis pubis; which can be considered with that of the humerus as forming the two extremes of the series of moveable articulations.

All the articulations of which I have spoken are with contiguous surfaces; this is the general character of those which are moveable. There is however an exception to this rule; it is the articulation of the body of the vertebrÆ, in which there is continuity and mobility. The symphysis pubis is also in part continuous in its surfaces, and yet has sometimes obscure motions. Hence arises a division of the moveable articulations, into those with continuous surfaces, and into those with contiguous ones.

Immoveable Articulations.

The immoveable articulations are sometimes with surfaces inserted into each other, as the bones of the cranium, in which many projections and depressions reciprocally receive each other; sometimes with surfaces in juxta-position, as in the articulation of the temporal with the parietal, the two superior maxillary bones with each other; sometimes with implanted surfaces, as in the teeth.

All the different divisions that I have mentioned will be easily understood by the following table; it is not the same as that which I have given in my treatise on the membranes; I think it presents a classification a little more useful in this, that it offers for a characteristic two things essential to be known in all kinds of moveable articulations, viz. 1st, the relation of the articular surfaces which characterizes the orders; 2d, the number of motions of each which distinguishes the genera. There are no orders in the immoveable articulations because, except the relation of surfaces, the articulations have not differences sufficient to occasion them to be sub-divided.

After having thus divided the articulations, let us offer upon each class some general observations. But let us first remark that the preceding table, considered in respect to the moveable articulations with contiguous surfaces, indicates perfectly the disposition of these articulations as to luxations, which are so much the more frequent as the motions are more extensive. The first genus is the most exposed to it, the last the least so; and the others are more or less so according to their distance from the first.

II. Observations upon the Moveable Articulations.

The class of moveable articulations is the most important to be considered, because their mechanism is the most complicated of the two orders composing this class, as we have seen. The latter, or that of the articulations with continuous surfaces, will not be considered in our general observations, as it embraces only one species of motion, that of the vertebrÆ, this motion will be noticed in the examination of the spine. The order of the moveable articulations with contiguous surfaces, comprises, as we have said, five genera characterized by their respective motions.

First Genus.

Extensive opposition, circumduction and rotation characterize this genus. The first by the extent and number of its motions. The articulations of the humerus with the scapula and the femur with the ilium are examples of it; they even exclusively compose it.

We see why it is at the superior part of the limbs that nature has placed this genus. A double advantage results from this situation. On the one hand, very far from the part of the limb immediately exposed to the action of external bodies, it more easily escapes luxations to which its want of solidity renders it liable. On the other hand, it can by this situation give to the limb the motions of a whole which compensate for those of the inferior articulations, the solidity of which prevents the power of motion in all directions. For example, the two articulations of which I have just spoken, are not only the articulations of the bones that form them, of the humerus and the femur, but also the articulations of the whole limb, which they direct in different directions; thus the anchylosis of these articulations renders the limb completely useless, whilst that of the inferior articulations only destroys partial motions.

The kind of motion of this genus of articulation requires a rounded form in the articular surfaces, whether they be concave that receive and convex that are received. This form is in fact the only one that can accommodate itself to extensive opposition, rotation and circumduction united; this is the form of the superior parts of the humerus with the scapula, and the femur with the os innominatum. The bone which moves has a convex surface, that which serves for support a concave one. There are in animals examples of an opposite arrangement: that is to say that a concavity is moved in all directions upon a convexity; but this is not found in man.

Though the two limbs have between them the greatest analogy in their motions, yet there are some differences relative especially to their respective uses, which in the one are for seizing and repelling bodies, in the other destined to locomotion. The principal of these differences is, that rotation and circumduction are found in them in an exactly inverse ratio. The mechanical reason and advantages of this arrangement are easily understood.

In the femur the length of the neck which is the lever of rotation, gives much extent to this motion, which supplies the pronation and supination that are wanting in the leg; so that every rotation of the foot is a motion of the whole of the limb. In the humerus on the contrary, the neck being very short and bringing the axis of the bone near the centre of the motion, limits rotation, which is less necessary on account of that of the fore-arm; the motion of the hand without or within is never communicated but by a part of the limb.

As to circumduction, the length of the neck of the thigh is an obstacle to it. In fact, let us remark that this motion is much the more easy, when it is performed by a rectilinear lever, because then the axis of the motion is the axis of the lever; that on the contrary, if the lever is angular, the motion becomes so much the more difficult because the axis of the motion is not that of the lever; and in general we can say, that the difficulty of the motion is in the direct ratio of the distance of the two axes.

This being settled, let us observe that the axis of the motion of circumduction of the thigh is evidently a straight line, obliquely directed from the head to the condyles, and distant consequently above from the axis of the bone, the whole length of the neck. Now, from what has just been said, it is evident, that the difficulty of circumduction will be in the direct ratio of the length of the neck, and consequently very great. In the humerus, on the contrary, the neck being very short, the axis of the bone and that of the motion are almost the same; hence the facility and extent of the circumduction. We might fix precisely the relation of these motions by this proportion; the circumduction of the humerus is to that of the femur, as the length of the neck of the humerus is to the length of the neck of the femur; which shows us how much more difficult the circumduction of the femur is than that of the humerus. To know this, it is sufficient in fact to know the excess of the length of the neck of the first over that of the second.

It is easy to perceive the advantages of this very great extent in the circumduction of the superior limbs destined to seize, and of the limits placed by nature to that of the inferior limbs destined to standing and locomotion. We understand also why luxations are more easy in the first than in the second. The displacement almost always takes place in fact, in one of the simple motions, the succession of which forms the compound motion of circumduction, for example, in elevation or depression, in adduction or abduction, &c. Now all these motions being carried much further in the humerus than in the femur, the surfaces are more easily separated.

Second Genus.

This genus differs from the first by the absence of the motion of rotation. Opposition and circumduction are alone met with in it. We find examples of it in the temporal maxillary, sterno-clavicular, radio-carpal, meta-carpo-phalangeal articulations, &c.

The want of rotation evidently supposes, from what has been said above, the absence of an osseous head, the axis of which would make, as in the preceding genus, an angle with the axis of the body of the bone. Thus in all the bones of the articulations that I have just mentioned, the articular surface is at the extremity even of the bone, and not upon the side; the axis is the same in both cases. They form a rectilinear lever, instead of an angular one.

The articular surfaces are in general, as in the preceding case, uniform, without eminences and reciprocal depressions; which would embarrass and even prevent circumduction. In the bone which serves for support, there is a cavity more or less deep; in the bone which is moved, there is an analogous convexity. The corresponding surfaces of the temporal and the inferior maxillary bone, of the bones of the metacarpus and the first phalanges, are examples of this arrangement.

This articular mode is the most favourably disposed for circumduction, which is, as we have seen, constantly in the inverse ratio of rotation, and which consequently has the greatest possible facility when the lever is rectilinear, a circumstance that destroys rotation. Yet in many articulations of this genus, circumduction is evidently less extensive than in the humerus and the femur; but this arises from the arrangement of the moving powers which being in much greater number in the articulations of these two bones, compensate for the bad arrangement of the articular surfaces for circumduction.

In the genus of articulations of which we are treating, there is always one direction in which the motion of opposition is more easy than in the others; for example, it is elevation and depression in the jaw, flexion and extension in the first phalanges, in the wrist, &c. In general there are two lateral ligaments and the capsule in the direction in which the motions are most limited, the capsule only in that in which they are the most extensive.

Third Genus.

As we advance in the examination of these articular genera, the extent of their motion diminishes. This has less opposition in many directions than the preceding, and less circumduction which always supposes an extensive opposition. Here this opposition is always limited to one direction only, to that of flexion and extension, for example.

We find this articular genus especially in the middle of the limbs, as at the elbow, the knee, the middle of the fingers in the articulations of the phalanges. Though the bone which composes them, inferiorly can move by itself but in one direction, yet it borrows from the loose motions of the superior articulation of the limb, so as to be able to be turned in every way.

The articular surfaces are found here as in the preceding genus, at the extremity of the bone, having the same axis as the bone; but they differ, 1st, in this that there are many eminences and cavities fitted to each other, an arrangement, which, by permitting the motion in one direction, prevents it in the others. Very commonly there are two kinds of round prominences, called condyles, which roll from before behind, or from without within, &c. upon two analogous cavities, that are separated by an eminence, which is received in the space between the condyles, as we see in the femoro-tibial, phalangeal articulations, &c. 2d. The breadth of the surfaces also distinguishes this genus from the preceding; this breadth insures its solidity, and prevents luxations, which besides are more to be feared when they happen here where more ligaments must be broken than elsewhere.

There is always in this genus greater extent of motion on one side, than on the opposite. In general flexion has always more extended limits than extension; observe in fact the condyles of the femur, of the phalanges, &c. they are extended much further in the first than the second direction; why? because all our principal motions are those of flexion, and the motions of extension are as it were but to moderate the first, and have for their object only to bring back the limb to the position from which it can be bent again. Hence why the number, and the strength of the fibres are much greater in the flexors than in the extensors; why the great vascular and nervous trunks are always on the side of flexion, as we see in the thigh, the leg, the fore-arm, the phalanges, &c. There is always something which limits the motion of extension, as the olecranon in the humero-cubital articulation, the crucial ligaments in the femoro-tibial articulation.

Though in the genus which we are describing, there is no well marked motion of circumduction, yet when the leg or the fore-arm are in flexion, they can move laterally and even in the form of a cone, but not in a very evident manner. In extension this is impossible, because the lateral ligaments being much stretched, do not yield enough to allow the bone to incline from one side to the other.

Fourth Genus.

Every kind of opposition and circumduction is wanting in this genus, which presents rotation alone, as we see in the articulations of the ulna with the radius, and the atlas with the odontoid process. Sometimes it is a concave surface rolling upon a convex one, as at the lower end of the radius, and at the odontoid process; sometimes it is a convex surface moving upon a concave one, as at the head of the radius; there is always a kind of ligament which completes the concave surface, and which thus forms a ring turning upon the bone, or in which the bone turns.

Luxations are here very difficult, because the rotation being made upon the axis of the bone, the ligaments are hardly more distended on one side than the other, and are hence broken with difficulty, whatever may be the extent of the motion. The inferior part of the radius forms a slight exception to this rule, because it is upon the ulna, and not exactly upon its own axis, that the bone turns in this place.

There is no rotation in the leg as in the fore-arm, because, as we have seen, that of the thigh which is very extensive, supplies the place of it; which the humerus could hardly do for the fore-arm, as we know when this last is anchylosed.

Fifth Genus.

Every kind of rotation, opposition and circumduction are wanting in this genus, which is the most numerous, and which embraces the articulations of the carpus, the metacarpus, the tarsus and metatarsus, of the vertebrÆ between themselves by their articular processes, of the atlas with the occiput, of the humeral extremity of the clavicle, the sternal of the ribs, and the superior of the fibula. There is only a kind of slipping more or less obscure, and in which the osseous surfaces hardly ever leave each other. These surfaces are almost all plain, very close together, united by a considerable number of ligaments, and so strong in their connexion, that luxations hardly ever happen to them. Another reason moreover which renders them difficult, is that all this genus of articulations belongs almost wholly to short bones; now we know, that the motion imparted to a bone has a power of action which is in direct ratio of its length, and in the inverse of its smallness; for example, the same power applied to the tibial extremity of the femur, would luxate much more easily the ischiatic extremity, than if it acted upon the middle of this bone.

As the separate motion of each of the articulations of the fifth genus is almost nothing, nature usually unites several at the same place, for the purpose of producing a sensible, general motion, as we see in the carpus, the tarsus, the vertebrÆ, &c.; this is also a reason of the difficulty there is in luxating this genus of articulations. In fact, how great the general motions may be, two bones, taken separately, move but little upon each other; now it is only the extent of the motion of the two separate bones from each other, that can produce the displacement.

III. Observations upon the Immoveable Articulations.

We have only pointed out orders in this class, because its varieties are not sufficiently great to assign genera for them.

1st. The order of immoveable articulations with surfaces in juxta-position, is met with where the mechanism of the part alone is almost sufficient to insure the solidity of the bones which are found only placed at the side of each other, without holding by any insertion, and having only between them a slight cartilaginous layer; the superior maxillary bones, wedged in between the malar bones, the ossa ungues, the ethmoid, the ossa palati, the vomer, and the frontal bone, are supported more by the general mechanism of the face, than by any articular attachments that unite them to each other; thus the squamous portion of the temporal bone supports the parietal, more by the abutting arches, than by the manner of the union of their respective surfaces. Remove this general mechanism of the part, you will soon see all the articulations separate.

2d. The order of immoveable articulations with inserted surfaces, owes also in some measure its solidity to the general mechanism of the part; but this mechanism would be insufficient to insure this solidity; thus the bones, instead of having almost plain surfaces, exhibit very evident prominences and depressions which are inserted into each other, as we see in the articulations of the parietal bones with each other, with the sphenoid, the occipital, the frontal, &c.; these are called sutures. This order sometimes approximates the preceding, as in the union of the parietal and frontal bones, which, reciprocally aiding each other, are supported by this mechanism, more than by their insertions; sometimes it resembles the following order, as in the articulation of the occipital and parietal bones, in which the very deep insertions almost alone insure the solidity of the union. This order is never seen except upon the edges of the flat bones; the insertion of these edges compensates for their want of size, by multiplying the points of contact. The eminences and depressions forming the insertion are always of an irregular form and size. They are exactly fitted to each other, they are not alike in two bones of the same species, taken from two different subjects; so that we cannot unite to a detached left parietal bone, the right parietal bone of another individual. There has been much dispute upon the formation of the sutures; they are an effect of the laws of ossification, an effect which we can account for no more than we can for all the others, and all the general phenomena of growth; we shall see the progress they follow in this formation. This articular order is gradually effaced with age, and the bones unite together by the ossification of the thin intermediate cartilage. It is more rare that the preceding order disappears. I have seen, however, in extreme old age, different articulations of this order cease to be evident, those of the maxillary bones between themselves especially.

3d. The order of articulations with implanted surfaces borrows none of its solidity from the mechanism of the part; it owes it entirely to the relation of the surfaces, which are so united and embraced by each other, that displacement is impossible. There is but one example of this articular order, it is the teeth with the jaws.

Age does not here efface the articulation, and thus confound the two bones as in the preceding orders, because the medium of union is the palatine membrane, which belongs to the mucous system, and which by its organization has no tendency to ossification; whereas in the preceding cases, the intermediate cartilage has a natural disposition to become encrusted with the phosphate of lime.

IV. Of the Means of Union between the Articular Surfaces.

The articular surfaces would soon separate, if different organs did not retain them in place. These organs are the cartilages and the membranes for the immoveable articulations, the ligaments and the muscles for the moveable.

Union of the Immoveable Articulations.

The two first orders of immoveable articulations, those with inserted surfaces and those with surfaces in juxta-position, have cartilages between the osseous surfaces, the breadth and thickness of which are found so much the greater in proportion as they are examined in subjects nearest infancy. Almost all the bones of the head are held together in this manner, which allows them to yield a little, and consequently prevents their fracture.

In the articulations of the pelvis, there are besides the cartilages, ligaments; but as these articulations perform in certain cases small sliding motions, we can consider them as intermediate between the moveable and immoveable articulations; it is on this account that they have the two kinds of organs especially destined to strengthen the articular surfaces of each of the classes, viz. the cartilages and the ligaments.

The immoveable articulations with implanted surfaces, an order which comprehends only the teeth, have nothing between the surfaces as a means of union, but a mucous membrane, the palatine. Hence why in the swellings of this membrane, in scorbutic affections, after the use of mercury, &c. the teeth become loose.

Union of the Moveable Articulations.

The moveable articulations with contiguous surfaces have the ligaments especially as a means of union, which are found in the five genera, but under different forms which will be examined hereafter. This kind of organ unites much suppleness with great resistance, a double attribute which it derives from its peculiar texture, and which renders it very proper for this function. Let us observe however that these two properties are in an inverse ratio in the two extreme ages of life, that suppleness is the companion of infancy, that stiffness and resistance are the character of the ligaments in old age. Hence in part the multiplicity of motions in one age, and their slowness and difficulty in the other.

The cartilages are not in this articular order, as in the preceding, means of union, but means of motion, by their smooth and polished surfaces.

As to the synovial membrane that is found exclusively in this order, such is its extreme tenuity, that it can hardly be considered as uniting the surfaces, and its use appears to be confined to the exhalation of synovia.

It is not the same with the muscles; they can be considered as forming at the same time around the moveable articulations, a power for the whole of the bone, and a resistance for its extremities, which they prevent from being displaced, by forming around them supports, the efficiency of which is in proportion to the efforts that are made to displace these extremities. In fact, it is in the great motions that these efforts are the most considerable; now then the neighbouring muscles of articulation strongly contracted, hard during their contractions, have a powerful tendency to prevent the osseous extremity from abandoning that which corresponds with it. In rest when the relaxed muscles offer but little resistance, the effort for support is nothing. A paralyzed limb can be luxated much more easily than another, by external violence.

The order of moveable articulations with contiguous surfaces, has as a means of union, a substance, the nature of which is between that of the ligaments and that of the cartilages.

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ARTICLE FIFTH.
DEVELOPMENT OF THE OSSEOUS SYSTEM.

There is no system in which anatomists have traced in a more accurate manner than in this, the different states in the different periods of life. The remarkable difference of a bone examined in the first months when gelatine almost alone composes it, compared with a bone of an adult in which the calcareous substance predominates, has especially arrested their attention upon this point. Let us examine the phenomena of ossification in all the ages; these phenomena should be considered during and after growth. In general, while this continues, there are some portions of the osseous system not ossified, as the neck of the femur, for example; ossification is not complete, the bones are not perfectly developed until towards the sixteenth or eighteenth year, and sometimes even later.

I. State of the Osseous System during Growth.

We commonly distinguish three states in the development of the bones, viz. the mucous, the cartilaginous and the osseous states.

Mucous State.

The mucous state may be considered as existing at two periods: 1st. In the first days of the development of the embryo, a period in which the whole of its organs forms only a homogeneous and mucous mass, in which it is not possible to distinguish any line of demarcation, and in which the parenchymas of nutrition alone exist. All the organs are then of the same nature; the bones are in fact mucous like all the other organs, if by this word we understand a state in which the cellular texture existing alone with the vessels and the nerves, is penetrated by so large a quantity of juices, that it has the form of a mucilage, and gives the appearance of it to the embryo. 2d. We may understand by the words mucous state, that more advanced period of osseous nutrition, in which the bones can be already distinguished, seen through the transparency that the other parts of the limb still have, and in which they have a consistence much greater than that of the parts which surround them; now this state is only the commencement of that of cartilage; for the parenchyma of nutrition takes the cartilaginous character when it begins to be penetrated by gelatine, and it is in fact penetrated by this substance when it has more consistence, since it is that which gives it this consistence, and hence an existence distinct from the surrounding parts. If in the early periods, this cartilage is softer, if it flattens under the finger when pressed, if it even has an appearance partly mucous, it is because the gelatine is not yet in sufficiently large proportion, and because the nutritive parenchyma still predominates; gradually its quantity increases, and then the cartilaginous nature is more evidently developed.

It follows hence that the bones have three periods in their development; one is common to them with all the other organs; it is the mucous period; the two others especially characterize them; these are the cartilaginous and osseous periods. Let us examine their phenomena.

Cartilaginous State.

All the bones are cartilaginous before taking their last form. This state of cartilage begins at a period that is difficult to be determined; it is when on the one hand the circulating system begins to carry gelatine and present it to the organs, and when on the other the organic sensibility of the parenchyma of nutrition of the bones is put in relation with this substance. Then the consistence of the bone is constantly increasing, because the gelatine is constantly accumulating; now it accumulates in the same direction that the phosphate of lime afterwards takes; that is to say, in the long bones it is in the middle of the body, in the flat bones it is in the centre, and in the short ones it is in the centre also, that this substance is at first exhaled, which afterwards extends gradually to the extremities of the first, the circumference of the second and the surface of the third. I would observe however that we do not see, during the formation of the cartilaginous bone, those longitudinal striÆ in the long bones, radiated ones in the flat, irregularly crossed ones in the short, which distinguish the osseous state in its formation, and which seem to indicate to the eye the course of the phosphate of lime.

The cartilaginous state exhibits a peculiarity that distinguishes it from the osseous state; it is that all the bones that are to be afterwards united by means of cartilage, such as those of the cranium, the face, the vertebral column and the pelvis make only one piece; whilst all those that are to be held together by ligaments, whose articulations are consequently moveable, are found very distinct, as the femur, the tibia, the clavicle, &c.

The broad bones, those of the cranium especially, do not exhibit in so distinct a manner the cartilaginous state. Their appearance, at this period of ossification, is even rather membranous. It arises from this; as they are found interposed between the periosteum and the dura mater, and as their tenuity is very great, we can with difficulty distinguish them on the interior of these two membranes. But when we dissect the parts with care, we can distinguish the bone yet soft, from this double covering.

The cartilaginous state appears in the clavicle, the scapula, the ribs, before being discoverable in the other bones in which it is afterwards seen. When we examine the bones in this state, we find them of different consistence and solidity; where the exhalation of gelatine has commenced, they are incompletely cartilaginous; as we go from this point, they partake more or less of the mucous state. The cartilaginous bone has no internal cavity, no medullary system, &c.

Osseous State.

When the whole bone is cartilaginous, and even when some points appear to be still mucous, the exhalation of calcareous substance begins, and then the osseous state manifests itself; the following is the manner; the bone becomes more dense, then of a deeper colour, and finally of a very evident yellow in its middle, that is to say where the ossification should begin; gradually a red point appears; these are the vessels that begin to receive the red portion of the blood, and not to be developed as some anatomists pretend, to be hollowed out according to their expression, by the force of the impulse of the heart. They always existed; the white fluids alone penetrated them before, then the red globules are admitted into them. At the same time the neighbouring parts are encrusted with calcareous substance. This period is then remarkable in two particulars, viz. in respect to the entrance of the blood into the cartilaginous bone, and in regard to the exhalation of the phosphate of lime. These two phenomena are always inseparable; when there is redness in one part of the cartilages, there are also osseous points; this is observed not only in common ossification, but also in those which are not so, such as the ossifications of the cartilages of the larynx, of the ribs, &c. When we examine the progress of the exhalation of the earthy substance, we see always in the bones, whether long, flat or short, a very red vascular layer, between the cartilage and the portion of ossified bone. This layer seems to serve as a precursor to the osseous state. Why do the vessels of the bones which before had admitted only white fluids, receive then red globules? It is not, as Boerhaave would have said, had he treated of ossification, because their caliber increases, but because the sum of their organic sensibility increasing, they are then found in relation with the red portion, which until then was foreign to them. Their caliber might be treble or quadruple the diameter of the red globules, but these would not enter if the organic sensibility repelled them, as the larynx rises against a body which attempts to enter it, though this body may be infinitely less than the glottis. It is by an increase of organic sensibility, that must also be explained how the bone, until then a stranger to calcareous substance, being in relation only with the gelatine, appropriates also to itself the first of these substances, and is penetrated with ease.

I will observe only that there is this difference between the exhalation of the two, that the first comes immediately from the red portion of the blood, since wherever it is deposited, there is, as I have said, blood vessels; whilst the second appears to come immediately from the white fluids, since the vessels of the tendons, the cartilages and the other parts that they nourish, do not evidently receive in their natural state any red globules, and all that circulates in them appears to be white.

The osseous state commences with the end of the first month in the clavicle, the ribs, &c.; it is a little more slow in the other bones; we know not its precise period. The following is its progress in the three kinds of bones.

Progress of the Osseous State in the Long Bones.

We distinguish at first in the middle of these bones, a small osseous cylinder, very slender in its centre, enlarging towards the extremities, hollow in the interior for the rudiments of the medullary system, perforated by a nourishing foramen whose size is then in proportion very great, receiving also a very large vessel. This osseous cylinder, at first very slender in comparison with the cartilaginous extremities of the bone, is in a very evident disproportion to them in this respect; it is formed of very delicate fibres, and is gradually enlarged and extended, until it reaches near the extremities where it is found at birth; the most of these extremities are not then bony. Some time after, and at a period which varies in the different bones, there is developed in these extremities an osseous point which begins at the centre, and which is always preceded by the passage of the blood in the vessels. These new germs increase at the expense of the cartilage which is gradually lessened between the body and the extremity of the bone; at the end of some time there remains only a slight partition which ossification also seizes upon; so that the bone is then wholly osseous from one extremity to the other. The secondary points which are developed in the different apophyses, also unite; so that its substance is everywhere homogeneous. It is not until the age of sixteen or eighteen years, that nature has completely finished this work.

Progress of the Osseous State in the Broad Bones.

The mode of origin of ossification varies in this kind of bones. Those which are symmetrical, have always two points or more, which correspond upon each side of the median line; sometimes one of them is found upon this line. When these points of ossification are in equal number, they are always upon the sides; if they are in unequal number, one of them is upon the line.

The irregular bones sometimes have but one of them, as in the parietal; at other times many appear in them, as in the temporal; but there is never a similar arrangement among them; only they correspond with those of the opposite bone.

At the first point of ossification in a broad bone, we perceive at first reddish spots, then we observe the phosphate of lime spreading in rays from the centre to the circumference of the bone. The osseous rays are very evident upon the bones of the cranium. Portions not ossified at first fill their interstices, which new rays afterwards occupy. All terminate in an unequal manner, without touching, so that by separating an ossified portion of a broad bone from the membranous portion to which it belongs, its circumference looks cut like the extremity of a comb; hence, as we shall see, the origin of sutures.

The delicacy of these bones is extreme in the early periods; they have not then any of the texture of the cells. At birth but few of the osseous centres are yet united; cartilaginous and membranous spaces separate them; these spaces are greater towards the angles than towards the edges, and generally at points the most distant from the primitive osseous centres. The bones with many points of ossification are formed of separate pieces, more or less distant from each other. Those with one point only, have but one piece.

After birth these bones extend more and more, their thickness and hardness increase; they are divided into two compact layers, the space between which is filled by the texture of the cells; gradually they touch at their edges, and then the sutures are formed in the cranium; for there is this difference between their ossification and that of the long bones, that it takes place always from the centre to the circumference, and that new osseous points are not developed at the circumference to meet those of the centre. But when this happens, the union does not then take place as in the long bones, but sutures are formed; and it is this which occasions the ossa wormiana, which are so much the larger as the osseous point is the sooner developed, because it has had time to extend itself more, before meeting the general ossification of the bone.

When a broad bone is developed by many points and there exists upon its surface an articular surface, it is usually the centre in which all the points unite at the period in which ossification terminates; we see this in the cotyloid cavity, in the condyle of the occipital bone, &c.

There is often in the broad bones two well marked periods for their ossification; it is so in those which, like the sacrum and sternum, are developed by a great number of points. These points begin at first to unite into three or four principal pieces which divide the bone; this is the first period; then much later, the union of the pieces takes place; this is the second period.

Progress of the Osseous State in the Short Bones.

The short bones remain in general longer cartilaginous than the others. Often at birth many are still so, those of the tarsus and carpus in particular. The body of the vertebrÆ is ossified sooner; a point is developed at the centre, and extends over the whole surface.

These phenomena are nearly analogous to those of the ossification of the extremities of the long bones, which the short bones resemble so much. After birth, the whole cartilaginous portion, is, if we may so say, invaded by the calcareous substance, which mixes with it, and there is finally only the articular cartilages left.

There are bones, as the occipital and sphenoid, which partake of the character of the broad and short bones; their ossification is mixed, and follows the mode of one or the other, according to the part of the bone that we examine.

II. State of the Osseous System after its Growth.

The bones, having become completely ossified, continue to undergo different phenomena which anatomists have too much neglected. The general growth in height is terminated when ossification is complete; and it even appears that the term of these two is nearly the same; but that in breadth continues for a long time after; compare the small and slender body of a young man of eighteen years, with the stout and well proportioned one of a man of forty, and you will see the difference. The bones follow the general law; their nutrition is prolonged for their thickness, when that for their length ceases. It appears that then the vessels which penetrate by the foramina of the first and second order, do not contribute to this nutrition, which draws its materials from those of the third; now, as we know that these very superficial vessels are arrested in the external fibres of the bone, and do not penetrate within, we understand, 1st, how, the growth going on without, the bone increases in thickness; 2d, how this increase takes place especially on the compact texture, the proportional thickness of which is in the direct ratio of the age, as we may see by inspecting the different bones of the child, the adult and the old person.

This external growth has made it believed that the periosteum contributes to it especially by the ossification of its layers; but we shall see in the article upon this membrane, what opinion should be entertained upon this subject.

It is principally at this period in which the work of nutrition seems spread upon the osseous surface, that the different eminences, which are scattered over this surface, become more evident; then especially all the prominences of insertion become more prominent; there is in respect to these eminences a remarkable difference between the skeleton of a child and that of a full grown man. In the foetus they hardly exist, as we see particularly by the different apophyses of the vertebrÆ, the spinous especially. As these eminences are generally the most distant parts from the primitive osseous centres, it appears that it is to this circumstance that must be attributed the slowness of their formation, since ossification always goes from points where it begins, to the most distant ones.

When the bone has all its dimensions it still continues to be the seat of a very active nutrition; exhalation constantly brings to it gelatinous and calcareous substances which absorption afterwards takes up; so that it is continually composed and recomposed. The experiment with madder evidently proves this; if we feed an animal for some time upon this, the bones become red much more easily, in proportion as the animal is younger; so that by amputating a limb after some time, the bones have an appearance wholly different from what is natural to them; if, after this amputation, we discontinue the use of the madder for some time, and then amputate another limb, the bones will be found to have entirely resumed their natural colour; now we know that the calcareous substance is the vehicle of the colouring matter, since while the bones are only cartilaginous the madder has no effect upon them. The calcareous substance is then alternately furnished and taken away from the bones. Besides, the formation and resolution of exostoses, the softening and brittleness of the bones, the phenomena of the production of callus, &c. are they not an evident proof of the exhalation and absorption of this principle? It appears clearly that the urinary system is the way by which nature gets rid of the calcareous and even of the gelatinous substance. It would be curious to analyze accurately the urine of ricketty patients, and that of those affected with cancer; it is probable that the first of these substances predominates in the urine of the first, and the second in that of the others; I know of no positive experiments upon the subject.

Can we, by giving to patients gelatine or the phosphate of lime, restore to their bones the suppleness or solidity which they have lost? No, because it is necessary not only to introduce these substances into the economy but also to restore to the bones their peculiar organic sensibility which they no longer have, and which, by placing these substances in relation to them, would enable them to appropriate these to their own nourishment. The blood might be loaded with earthy and gelatinous principles, and the bones would repel these principles, so long as their sensibility was not in relation with them.

The double motion of nutrition continues always in the bones, as we advance in age; but its proportions change. The gelatine is constantly diminishing and the calcareous substance constantly increasing. Finally, in extreme old age this last predominates so much, that it would destroy their life, if general death did not take place before that of the bones.

It is to this that must be attributed the greyish colour that these organs then take; hence also their constantly increasing weight; hence consequently the difficulty of the motions of the limbs, since at the same time that the force of the muscular powers is diminished by age, the osseous resistance which they have to overcome increases.

At this period of life, the calcareous substance predominates so much in the economy, that it is thrown upon different organs, such as the arteries, the cartilages, the tendons, which then take the osseous character. We might say that by accumulating in our parts this substance foreign to life, nature wishes to prepare them insensibly for death.

In general, it is those organs whose nutritive substance is gelatine, which have the greatest tendency to be placed in relation with the calcareous substance, and consequently to be encrusted with it. Hence why the cartilages especially are ossified; why those of the sutures disappearing, the bones of the cranium become continuous; why the larynx is finally almost all osseous; why the cartilages of the ribs are often as solid as the ribs themselves; why oftentimes many vertebrÆ united form a more or less considerable continuous mass. I would observe however that the arteries, which have so great a tendency to ossification, are not so evidently gelatinous as many other substances which ossify much less easily, as the tendons for example.

III. Peculiar Phenomena of the Development of the Callus.

Nothing is easier after what has been said upon the osseous nutrition, than to understand the formation of the callus. We know that it has three periods, 1st, the development of the fleshy granulations; 2d, their change into cartilage; 3d, the change of this cartilage into bone. This triple phenomenon takes place in a space of time that varies according to the age, the fracture, the kind of bone, &c. but which is in general longer than that of the other cicatrices.

The development of fleshy granulations is a phenomenon common to every species of organ which has experienced a solution of continuity and whose divided edges are not in immediate contact. Here these granulations arise from every part of the divided surface, from the periosteum, the compact texture and that of the cells, the last especially. Those of one side unite to those of the opposite. Thus far the osseous cicatrix does not differ from that of the other parts. This state corresponds with the mucous state of natural ossification. As the fleshy fibres are but the extension of the nutritive parenchyma, they have its vital forces; their organic sensibility follows the same laws as in ordinary nutrition; at first it is in relation with gelatine; this is then exhaled; then commences the cartilaginous state; then the osseous cicatrix takes a peculiar character, which distinguishes it from that of the other organs.

At the end of a longer time, the organic sensibility increases in the parenchyma of cicatrization which the fleshy granulations form; then these become in relation with the calcareous substance which comes to the bone, and which they had until then repelled; they admit it then, as well as the red portion of the blood which always precedes it in every species of ossification.

Hence we see that the callus is cellular and vascular in the first period; that in the second it contains cellular texture and vessels, with gelatine; that in the third, it has cellular texture, vessels, and gelatine, with calcareous substance.

It has not the regular forms of the sound bone, because the parenchyma of cicatrization arising irregularly upon the osseous surfaces, the exhalation and absorption of gelatine cannot be made in a precise and regular manner. The callus is so much the larger in proportion to the separation of the ends of the bone, because the fleshy granulations having had more space to go over in order to meet, are more extensive, and consequently have absorbed more nutritive substance.

If the constant motion of the fractured ends prevents on each side the granulations, or what is the same thing, the two parenchymas of cicatrization from uniting, then, notwithstanding the exhalation of the nutritive substances in each of them, the bone does not unite, and hence the preternatural articulations.

Callus is formed with difficulty when the ends divided and laid bare, suppurate with the neighbouring parts, as happens in compound fractures, because the formation of pus expends the nutritive substances destined to repair the fracture. The further considerations upon this singular production belong to pathology.

I have not exposed in this chapter the ideas of the ancients, who thought that the bones were formed by the hardening of an osseous juice, the existence of which there is nothing to demonstrate; nor those of Haller, who imagined that the heart hollowed out arterial channels in the osseous substance by its own impulse, and hardened this substance by the pulsation of the arteries; nor those of Duhamel, who made every thing depend upon the periosteum; I refer to various works that have a thousand times refuted these opinions.

Without refuting any one in particular, I would remark that they have one fundamental error, viz. that of considering osseous nutrition in an insulated manner, of not presenting it as a division of general nutrition, of admitting for its explanation reasonings only applicable to the bones, and which are not derived as consequences from those which serve to establish the nutrition of all the organs. Let us never lose sight of this essential principle, upon which rest all the phenomena of the economy, viz. that over a multitude of effects, a very small number of causes only presides. Let us mistrust every explanation which is partial and mutilated, which circumscribes the resources of nature according to the limits of our weak understandings.

IV. Peculiar Phenomena of the Development of the Teeth.

The teeth, differing in part by their texture, from the other bones, have also a peculiar mode of nutrition which we shall now examine. But as the knowledge of this supposes that of the general structure of the teeth, it is proper to explain here that structure, referring their description to the examination of the bones of the face.

Organization of the Teeth.

The teeth are formed by two substances, one external, of a peculiar nature, called enamel, the other internal, which is the common base of it, and the texture of which is the same as that of the other bones. They have besides a cavity which contains a spongy substance, as yet but little known.

Hard Portion of the Teeth.

The enamel of the tooth is only seen around the crown; some anatomists have thought that it extended a little upon the root, an opinion founded no doubt upon the extreme whiteness that the root often has in detached teeth, and which makes it impossible to distinguish the line of demarcation. But a very simple experiment proves this demarcation; it consists in macerating the tooth in diluted nitric acid. The acid immediately attacks both the root and the crown which it softens; but the first becomes yellow like almost all animal substances exposed to its action, whilst the other preserves its colour, and even becomes whiter. This experiment also proves that their respective natures are essentially different.

The enamel, thick on the top of the crown, grows thinner towards the root, an arrangement required by its use, which is to defend the tooth, to support principally the efforts of mastication, which are made especially upon the top of the crown.

This substance hard, compact, particularly when it has remained a long time in the air, acted upon with difficulty by the file, is composed of very close fibres, the direction of which cannot be traced. The medullary oil does not appear to penetrate it; it does not burn, but breaks by the action of fire, and is thus separated from the other substance, which, exposed to heat, at first becomes black, then burns like the other bones and gives out the same odour.

Is the enamel organized, or is it only a fluid which, oozing at first from the external surface of the tooth, afterwards becomes there hardened and concrete? This question is not I think easy to be resolved. The enamel has in fact attributes which seem equally favourable to both these opinions. On the one hand it is sensible, like every thing that is organized; it gives us, much more evidently than the hair or the nails, the sensation of bodies which strike it. The diluted acids, the vegetable especially, raise its sensibility so much, that the least touch becomes very painful a long time after their use. The teeth are then, as we call it, on edge. On the other hand the enamel has many characters that seem to denote a want of organization. 1st. It never inflames, or becomes the seat of any tumour, or any alteration which softens its texture; it never experiences any alteration, which by raising its life, renders it more sensible than in a natural state, as happens to the hair, for example, which ordinarily insensible, has a very great vital activity in the plica polonica. In fact we often judge of the vitality of organs more by their morbid alterations, than by their natural state. 2d. It appears that there does not take place in the enamel alternate exhalation and absorption of nutritive matters, or at least if it does, it is not sensible. Rubbing wears away this substance, which is never replaced; this is remarkable in old people, and in those who are in the habit of often striking their teeth together. We know that we file the enamel like an inorganic body, and that it is not reproduced, whilst the hair and the nails evidently grow after being cut. File the extremity of a long bone after amputation; fleshy granulations will soon grow upon the filed surface; the action of the instrument will be a stimulus which will develop the vital phenomena.

The osseous portion of the tooth composes the whole of the root and the interior of the crown; it is formed by the compact texture, very dense, having great resemblance to that of stone. It has none of the texture of the cells. Its fibres, very close to each other, have various directions, very difficult to trace, but which in general follow that of the roots; it is necessary, in order to see this direction perfectly, to soften the teeth in an acid.

Each tooth has a cavity situated in the crown, of the same form as the crown, diminishing in diameter as we advance in age, communicating externally by small canals, the number of which is equal to that of the distinct roots of the tooth, and which open at the end of these roots. This cavity is lined by a very delicate membrane on which the vessels ramify, and which, with its opposite face, covers the marrow.

Soft Portion of the Tooth.

This is a spongy substance which appears to be formed by the interlacing of the vessels and nerves belonging to each tooth, but the nature of which is not yet well understood; we know only that it has a very great animal sensibility equal to that of the medullary organ. This is proved, 1st, by the pains of carious teeth in which the marrow is bare, and which are, as we know, extremely acute; 2d, by the introduction of a probe into the opening occasioned by caries, this produces no pain until it comes to the marrow, and then it is extreme; 3d, by opening a socket of a very young animal that has not yet cut its teeth. At this age the marrow is very considerable and the tooth being small in proportion, it is easy to raise the tooth without injuring it, because it has as yet no root and the opening at the base of the crown is very large. The tooth being raised and the marrow thus laid bare, if it is irritated in any way the animal gives signs of the most acute pain. I have often made this experiment, always easily done, on account of the want of thickness of the osseous layers which then form the sockets.

The teeth have remarkable sympathies, which extend not only to the solid part, but also to the marrow. As this is much greater in proportion in the early ages, as it is almost the predominant part of the tooth, these sympathies are then more numerous and evident. In these sympathies, sometimes the animal and sometimes the organic properties are brought into action.

The sympathies of animal sensibility are evident in those pains of which the teeth become the seat from the action of cold or moisture upon the cutaneous system; in those produced in the face and the head by the caries of a tooth. Fauchart relates a case of obstinate hemicrania, which was immediately removed by the extraction of a tooth. The sensibility of the ear and the eyes is changed in some violent cases of tooth ache. The animal contractility is also brought into action in the sympathies of the teeth; nothing is more frequent in dentition, than convulsions of the voluntary muscles. Tissot speaks of a spasm of the muscles of the jaw, which was cured by the extraction of two carious teeth, and of a convulsion in the muscles of the neck that occasioned death, the primitive source of which was in a decayed tooth.

The organic sympathies are not less often produced by affections of the teeth. Spasmodic vomiting, diarrhoea, frequency of the pulse, oftentimes involuntary evacuation of urine, phenomena, over which the sensible organic contractility of the stomach, the intestines, the bladder and the heart presides, are the frequent effects of dentition and violent pains of the teeth, especially of the first. The insensible organic contractility, and the organic sensibility are brought sympathetically into action in the enlargements of the parotid gland, in the general swelling of the face, in the increased secretion of saliva and sometimes in the erysipelatous inflammations which take place from an acute affection of the teeth.

The sympathies of the teeth often take place between the two corresponding teeth of the same row or of the two rows. My first upper molar tooth of the left side is a little carious; from time to time it gives me pain, then invariably the first molar tooth of the right side becomes as painful, though it is sound. There are other cases in which a tooth being painful below, sympathetic pains are felt in that which is above, and vice versa.

The structure of the teeth having been explained, let us see how their different substances are developed. This subject of osseous nutrition does not appear to me to have been clearly illustrated by any author. I shall attempt to explain it better. There are two dentitions, one is provisional and limited to the first age, the other belongs to the whole life; each should be considered before, during, and after the cutting of the teeth.

First Dentition considered before Cutting.

The phenomena of dentition before the period of cutting are these; the jaws of the foetus are closed the whole length of their upper edge; they appear to be homogeneous at first view; but examined in their interior, they exhibit a row of small membranous follicles, separated by delicate partitions, disposed like the teeth of which they are to serve as the germ, and having the following arrangement.

The membrane which serves as a covering to the follicle forms a sac without an opening, which lines at first all the parietes of the socket, to which it is attached by elongations. At the place where the vessels and nerves enter, this sac leaves the socket, becomes detached, is folded into the form of a canal which accompanies the vascular and nervous bundle, and afterwards spreads out upon the marrow of the tooth which is the termination of the bundle.

It follows from this that this membrane has the general conformation of the serous membranes, in the shape of some kinds of night-caps. It has two portions, the one attached and lining the socket, the other loose and covering the marrow, as for example, the pleura has a costal and a pulmonary portion. The marrow and the vessels, though contained in its duplicature, are in truth found without the cavity, which is lubricated by a simple exhalation. I have found that this exhalation was like that of the serous membranes, essentially of an albuminous nature; the action of the nitric acid, that of alkohol and of fire incontestably prove it. Subjected to the action of one of these agents, especially the first, the membrane whitens immediately. The layer of albumen which covers it becomes concrete and coagulated, as when we make a similar experiment upon a serous surface.

The marrow, very considerable at this period, is found suspended, like a bunch of grapes, from the extremity of the vessels and the nerves.

It is upon the medullary portion of the membrane of the follicle, and upon the surface of its loose extremity, that the first osseous point is developed; it soon extends, and takes precisely the form of the top of the crown, which it is afterwards to form, that is to say, that it is quadrilateral in the molar teeth, pointed in the canine, and wedge shaped in the incisors. Developed at first nearest the gums, it extends afterwards along the vascular and nervous stem, it is moulded upon it as it approaches the part of the alveolus where it enters; so that it exhibits on this side a concave surface which embraces the pulpy portion of the membrane, and adheres by several vascular elongations; and as this portion is loose, the first rudiment of the tooth floats also in the cavity of the membrane, as we can see very well by cutting the alveolar portion of this membrane, after having destroyed the corresponding part of the alveolus.

The following consequences result from this kind of development; 1st. The crown is first formed, and the root is not produced but as the ossification in length advances upon the portion of membrane lining the vascular and nervous bundle. 2d. As all the vessels that come to the tooth enter at its internal surface, and as the external is entirely free in the cavity of the membrane, the ossification in thickness is made especially at the expense of the internal cavity which is constantly contracting, as well as the marrow, an arrangement, the reverse of that of the other bones, the ossification of which commences at a point placed in the centre of the cartilage, and which at first solid in the middle, afterwards become hollow for the medullary cavities and those of the cells, which are always enlarging. 3d. After the ossification of the tooth, the portion of the membrane of the follicle which lined the alveolus, remains the same, whilst that its portion corresponding with the marrow, originally free at the other side, becomes adherent on this side to the whole dental cavity which it lines, of which it forms the membrane noticed above in the article on the structure of the teeth, and which is thus found between the marrow and the osseous substance. 4th. The marrow of the tooth is the part first formed, and the most considerable in the first periods of life. It appears that the osseous substance is next formed, and that the enamel afterwards arises on the exterior of this. I have not yet been able to make evident the manner of its origin.

It is difficult to ascertain at what period the membraneous follicle is formed; that of the first ossification appears to be from the fourth to the fifth month. At the time of birth, we find the twenty teeth of the first dentition already advanced; the whole crown is formed; the beginning of the root appears also in the form of a broad tube, with extremely delicate parietes, and which is constantly becoming longer and thicker; when it reaches the bottom of the socket, the tooth immediately appears externally as this is too narrow to contain it.

The number of teeth, less in the first than in the second dentition, gives a peculiar form to the jaws of the foetus and the infant, especially to the lower one, which is less elongated in front, and consequently wider in proportion than in the adult, in whom in order to receive all the teeth, the alveolar border must necessarily be more extended. This arrangement of the lower jaw has a great influence in the expression of the physiognomy.

First Dentition considered at the period of Cutting.

The following phenomena take place about the sixth or seventh month after birth, very rarely sooner, still more rarely before birth, though there are examples of this, as is proved by the history of Louis XIV. At first the two small incisor teeth of the lower jaw appear, sometimes together, sometimes separately; soon after the corresponding incisors of the superior jaw. A month or two later, the four other incisors are cut. At the end of the first year, the four canine teeth usually appear. At the end of the second, or often later, two molar are cut in each jaw and two others soon follow. Each cutting almost always begins in the lower jaw. At the age of four years, four and a half, sometimes five or six, always at a very uncertain period, there appear below two other molars and then two above, which complete the number of twenty-four teeth forming the first dentition; all these except the last four fall out and are replaced by new ones.

The following is the mechanism of this first dentition; the ossification extending constantly towards the root, the tooth can no longer be contained in the socket; it pierces the alveolar portion of the membrane and the mucous membrane of the mouth and an intermediate medullary texture that separates them, with much ease, as this triple layer gradually becomes thinner as the cutting approaches. Is this phenomenon owing only to the mechanical pressure of the tooth? I think that there is another cause; for observe that here the membranes are very little raised before rupturing; whilst that in polypi and other tumours that sometimes arise under the membrane of the gums, it is infinitely more stretched, still it does not break, but is only lifted up. The mechanism of the opening of the gums is not more known than the principle of the severe accidents which are sometimes connected with it. The sac which formed the original membrane of the follicle being thus open, its portion which lines the socket unites to the membrane of the mouth, becomes continuous with it and at the same time adheres intimately to the neck of the tooth; and as during the development of the root, the internal face of this membranous portion, at first loose as we have seen, has gradually contracted adhesions with it, it follows that this root is found fastened between the alveolar portion which lines its exterior, and the medullary portion which covers the interior; it is this which gives it solidity. As the adhesions of the membrane increase, we can less easily distinguish it. It is rare that in the first dentition the formation of the root is finished as completely as in the second; its internal cavity remains also very broad, and the marrow is more developed.

Second Dentition considered before Cutting.

It is necessary, as in the preceding case, to distinguish the nutritive phenomena into those which take place before, during and after the cutting. Before the cutting, we observe by opening the jaw, a row of dental follicles, corresponding to the row of teeth already formed, situated below or at the side, and separated from them by little partitions, the thickness of which is found greater in proportion as it is examined nearer infancy.

These follicles have precisely the same arrangement as those of the first dentition; like them they form sacs without an opening, the alveolar portion of which is attached, and the loose medullary portion is covered on its surface with the first osseous layers for the crown. The manner of growth is the same; that is to say, it takes place from the exterior to the interior, the reverse of the other bones; an arrangement, which gives the part of the tooth immediately in contact with foreign bodies, being the first formed, time to acquire the solidity necessary for its functions.

As the second teeth grow, their vascular system becomes greater, and that of the old ones diminishes; which arises from this, that the sensibility weakened in the last, draws to them no more blood, whilst being raised in the others, it attracts it powerfully. We observe also that the partition of the sockets diminishes in thickness, and that the root of the first is destroyed. This double phenomenon does not appear to be owing to the pressure exerted by the new tooth, as then the root would spread and become flat only; or if it experienced a real destruction, we should find the remains of it, which we never do. It is then probable that, it is by the absorption of the phosphate of lime, that the partition and root disappear, nearly as we have said the internal cavities of the cartilaginous bones are formed.

We see from this, that the ossification of the roots of the first teeth is of short duration; it begins the last and terminates the first. When it is of but little extent, the teeth become loose, from the want of insertion. The disappearance of the partitions increases it. It is at about the age of six or seven years that the shedding of them commences; this takes place in the order in which they were cut, that is to say, first the incisors, then the canine, and then the molars. Observe that the last, which appeared at four years of age, are not renewed.

Second Dentition considered at the period of Cutting.

During the cutting of the second teeth, we observe them come out in the same order as those with which they correspond are detached. 1st. The eight incisors. 2d. The four canine appear. 3d. In the place of the first molar, two new ones are cut; these afterwards have the name of small molars. 4th. The second molar remains, as we have just said; it is the first of the great ones. 5th. At eight or nine years of age, two other molars appear in each jaw. 6th. Finally, at eighteen, twenty, or thirty years, and sometimes later, a third molar is cut; this is called the dens sapientiÆ.

There is then in each jaw sixteen teeth, of which four are incisors, two canine, two small molars, and three large ones.

Sometimes the second teeth while they are forming, instead of appropriating to themselves the nutritive substance of the roots of the first and their partition, leave them untouched; neither are destroyed; and the second teeth are cut at the side of the first which remain in their places. When this phenomenon happens, it is usually only to a single tooth; sometimes, however, it happens to many and even all, and then there is a double row. In general, the second teeth have a tendency to go out at the side of the gums. When very obliquely placed, by a defect of conformation, their crown leans forward or backward; instead of piercing the jaw, they remain always buried in the sockets.

Phenomena subsequent to the Cutting of the Second Teeth.

After being cut, the teeth evidently grow, 1st, in length; 2d, in thickness. It is only the root that is enlarged in the first direction; the crown preserves always the same dimensions; and if in old people it appears longer, it is only because the gums have retracted; a phenomenon which besides we very often observe in persons who have become thin, in those who have made use of mercury, &c.

The growth in the second direction is not made without, but only within; the canal of the root and the cavity of the body are constantly contracting, and are finally obliterated. Then the tooth receiving no longer the blood or the influence of the nerves, dies and falls out. But this death appears also to be hastened by the accumulation of osseous substance, of a very great quantity of the phosphate of lime, which predominates there so much over the gelatine, that the principle of life is entirely destroyed, so that in this respect, the shedding of the teeth exhibits a phenomenon analogous to that of the shedding of the horns of the herbivorous animals, of the calcareous shell of the crustaceous ones, &c.

Why has nature given to the life of the teeth a shorter term than to that of the other bones, which do not cease to exist but with the other organs, whilst the teeth die a long time before? Is it because the stomach becoming weak with age, the animals are thence compelled to nourish themselves in their old age, with soft substances, adapted to the languid state of the gastric forces? Undoubtedly in man, a thousand causes, arising especially from the nature of the aliments, their degree of heat and cold, the manner in which they are cooked, their infinitely various qualities, hasten the natural period of the death and the fall of the teeth, because by incessantly exciting and stimulating these organs, they keep them in a state of constant activity, which exhausts their life sooner than it otherwise would have been. Thus a thousand causes arising from society, make the term of the general life much shorter than that fixed by nature. But in general in all animals, the death of the teeth precedes that of the other organs, though they are not under the influence of society, and they masticate only aliments destined by nature to be in contact with their teeth.

The jaws destitute of teeth in old age, contract; the sockets are effaced; the texture of the gums becomes firmer, and mastication is continued, though with more difficulty. In this change of conformation, the alveolar edge is thrown back; hence the prominence of the chin before. It diminishes in height; hence the approximation of this part to the nose, a phenomenon that arises especially from the absence of the teeth.

V. Particular Phenomena of the Development of the Sesamoid Bones.

The sesamoid bones exhibit a less marked exception than that of the teeth, to the general laws of ossification, but one, however, which is as real.

General Arrangement of the Sesamoid Bones.

These small bones, commonly of a round form, and of various size, do not usually exceed that of a pea, except however the patella; they are in general found only in the extremities; the trunk never has any of them.

In the superior extremities we hardly see them, except in the hand, in which the articulation of the thumb with the first bone of the metacarpus always presents two of them, and in which they are sometimes found in the analogous articulation of the index finger, rarely in that of the little one, or in the phalangeal articulation of the thumb.

In the inferior extremities on the contrary, they are numerous and especially much more evident. Two are seen on each condyle of the femur, in the tendons of the biceps, behind the knee; in front is the patella. In the foot, the tendon of the tibialis posticus near its insertion in the tuberosity of the scaphoid bone, that of the peroneus longus in its passage under the cuboid, have also sesamoid bones. We uniformly see two under the metatarso-phalangeal articulations of the great toe; under most of the analogous articulations of the other toes, they are also found, though they are more variable. In the phalangeal articulations I have also seen them many times. In general, the sesamoid bones exist only in the direction of flexion, which is that in which the greatest efforts to support are made. In the direction of extension I know no one but the patella.

These little bones have not, like the others, a separate existence; they are developed always in a fibrous organ, either in a tendon, as those of the biceps, the peroneus, the tibialis posticus, as also the patella; or in a ligament, as all those placed before the metacarpo-phalangeal articulations, the metatarso-phalangeal or phalangeal, which have for their basis the great transverse fibrous fascia, which we have called the anterior ligament of these articulations.

Fibro-Cartilaginous State.

The two primitive bases of the sesamoid bones remain for a long time without exhibiting any rudiments of them, and are at the place where these bones are to exist as they are everywhere else. Their organization is generally uniform. Some time after birth, a little more gelatine than would serve for the nutrition of these two fibrous bodies begins to be exhaled at the place where the sesamoid bones will hereafter be found; then arise cartilages, essentially different from the cartilages of ordinary ossification, which are nearly of the same nature as those of the extremities of the long bones of adults, whilst that these belong truly to the class of fibro-cartilaginous substances. They resemble in their nature the inter-articular fibro-cartilages, those of the tendinous grooves, &c. These are not cartilages, but the fibro-cartilages of ossification, of which we distinguish so much better the fibrous base, as it is nearer the period of their development that we examine them.

Osseous State.

Gradually the vessels of these fibro-cartilages, which had only circulated white fluids, have their sensibility placed in relation with the blood; this fluid penetrates them; at the same time the phosphate of lime begins to be deposited in them; then the texture of the cells is formed in the interior by a mechanism analogous to that of the other bones; a delicate compact layer is developed on the exterior. But in the midst of this new bone, the fibrous base always remains; the fibres of the tendon, above the sesamoid, are continued, if we may so say, through its substance with those below it; thus the cicatrices of these bones, when they are fractured, have a peculiar and distinctive character; it is their fibrous base, which extending itself for their reunion, produces this difference. We know that the callus of the patella is not the same as that of the other bones. Often when the apparatus has not been exactly kept in place, there remains between the two fragments a fibro-cartilaginous texture as a means of union; now this texture is the development not only of the cartilaginous portion of the bone, but also of the portion of the tendon of the extensors, which makes part of the organization of this bone. The life of the sesamoid bones partakes almost as much of that of the fibrous as of that of the osseous system.

As we advance in age, these small bones increase and become more characterized in the animal economy; oftentimes they are developed very late, at the age of twenty, thirty, or even forty years. In some old people they are very large on the foot. I have seen the bodies of two persons subject to gout, in which they were so developed as probably to interfere with motion. Was there any connexion between them and this severe affection? I know only these two facts.

The sesamoid bones elongate their tendons from the centre of motion, facilitate their sliding upon the bones, defend their articulations and even contribute to their motions. All those developed in the anterior ligaments of the metacarpo and metatarso-phalangeal articulations, and of the phalangeal themselves, contribute also to the motion of these articulations. A portion of the synovial membrane is spread upon their face that corresponds with it, and which remains slightly cartilaginous.

The formation of the sesamoid bones is not a mechanical effect of the pressure of the tendons or the ligaments against the bones, as has been said, but the result of the laws of ossification. In fact, in the first supposition, why should all the articulations of the hand and the foot, other than those pointed out above, being exposed to a motion nearly equal to the motion of these, be destitute of these bones?

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