Dr. T. Tóth szerk.: Studia historico-anthropologica (Anthropologia Hungarica 21. Budapest, 1990)

generalisata of the Recklinghausen type. In cyanotic congenital heart malformations PH frequently develops as the organism attempts to compensate the insufficient oxygenation by increased red blood cell production. These cases can be separated from PH of different etiology if the tubular bones bear radiographic and/or macroscopic/microscopic features of hypertrophic osteopathy. In these cases large bark-like periostal bone formation can be seen on the tubular bones of the distal phalanges. When phalangeal bones are available, hippocratic deformities of the distal phalanges always indicate cyanotic conditions. The metastatic process is characteristic for malignant tumours (except tumours of the central neural system). Bone metastasis was found in 36.7% of almost 3,000 recent tumour cases by autopsy and/or histological analysis. Though malignant tumours were less frequent is historical material than nowadays we have no reason to presume that the biological characteristics and metastatic features of tumours changed at all. Nowadays, tumorous metastasis is very rare below elbows and knees. Only 0.6% of all bone metastasis occurs on the distal bones of limbs (LISZKA & al. 1989). Their vast majority can be located on the skull, on the spine, the pelvis, the thigh-bones and on the ribs. These bones are the most frequent remains of skeletalized material. Gross macroscopica! analysis without sawing up is able to identify only a minority of metastases. Therefore, when PH caused by tumours, or tumorous anaemias is suspected it is well worth carrying out X-ray examinations. This way we have a fair chance to detect approximately one-third of all malignant tumours by bone metastasis. PATHOGENESIS OF PH No matter what the primary disease is erythroid hyperplasia of the bone marrow is a common factor of PH. Cell-rich marrow is formed in the cranial bones, and a certain degree of spatial disproportion develops. Lamina externa is thinned out from the direction of diploe and then it is perforated. Finally it is completely destroyed over large areas. A subperiosteal proliferation of cell-rich bone marrow begins. Periosteal irritation brings about the formation of new bone material by the blood vessels of the medullary cavity. As the blood vessels of the medullary cavity are running perpendicularly to the outer cortical bone, the trabeculae formed parallel to these blood vessels follow a similar pattern. The bone marrow proliferates above the level of the lamina externa by these newly formed trabeculae. Parallel to this process lamina interna is gradually becoming thicker and thicker (MOSELEY 1965, HAMPERL & WEISS 1955). REFERENCES ADACHI, B. (1904): Die Porosität des Schadeldaches. - Ztsch. Morph. Anthropol., 7: 373-395. ANGEL, J.L. (1966): Porotic hyperostosis, anaemia, malarias and marshes in prehistoric Eastern Mediterranean. - Science, 153: 760-763. ANGEL, J.L. (1967): Porotic hyperostosis or osteoporosis symmetrica. In: Brothweli, D. A, Sandison, AT. (eds), Disease in antiquity, Springfield, Illinois: C. Thomas, 378-389. ASCENZI, A, BRUNORI, M., CITRO, G. & ZITO, R. (1985): Immunological detection of haemoglobin in bones of ancient Roman times and of Iron and Eneolithic ages. Proc. Nat. Acad. Sei., 82: 71707172. COOLEY, T. B. & LEE, P. (1925): Series of cases of splenomegaly in children with anaemia and peculiar bone changes. - J. Am. Pediat. Soc, 37: 29-45. EYRING, E. J. & EISENBERG, E. (1968): Congenital hyperphosphatasy.- J. Bone Joint Surg., 50A 1099-1117. FORNICARI, G., MALLEG NI, F., BERTINI, D. & NUTTI, V. (1981): Cribra orbitalia and elemental bone iron in the Punies of Carthage. - Ossa 8: 63-77. HAMPERL, H. & WEISS .P. (1955): Über die spongiöse Hyperostose an Schädeln aus Alt-PeruVirchows Arch.APafth. Anat. 327: 629-642.