Antall József szerk.: Orvostörténeti közlemények 55-56. (Budapest, 1970)

TANULMÁNYOK - Regöly-Mérei, Gyula: The Pathological Reconstruction of Semmelweis's Disease on the Basis of the Catamnestic Analysis and Palaeopathological Examination (angol nyelvű közlemény)

reactive ossification had started or not. Since there are only symptoms of bone disintegration pointing to inflammation, the process could not have lasted longer than just a few weeks. According to the bone symptoms the deformation was not of traumatic but of purulent inflammatory origin. On the left ribs signs of osteitis caused by an abscess — as described in the autopsy report — can be traced both macroscopically and histologically. On the lower third part of the right humerus a fracture-line healed with good callus is visible. There is no reorganization or defect, no thickening of the compacta, the medullary cavity is of usual largeness (Fig. 3). On the capitulum of the right Illrd metacarpus a patinated defect is visible (Fig. 4). The surface is porous, rough to the touch, at some places like the rind of tree. The cloaca communicates with the medullary cavity. On the capitulum of the right IVth metacarpus there are two, and on the base another cloaca opening, A similar deformation is visible on one of the metacarpal bones, the precise origin of which could not be cleared up because of the poor state of survival. The X-ray also points to osteomyelitis. The autopsy report does not mention osteomyelitis of the metacarpus. The examination of the tibiae is particularly important for the latter and the crar.ium are the praedilection sites of osteitis gummosa. The surface of the tibiae is smooth, their form normal, the medullary cavity of medium largeness and the walling of normal thickness (Fig. 5). Neither the X-ray nor the section (Fig. 6) show suspectable signs of syphilis. The two last lumbal vertebrae and two dorsal vertebrae distinctly reveal bone lace formation on the ventral part of the body. The macroscopic, microscopic and X-ray investigations of the other bones do not show deformation. Axhausen's Grenzstränge are characteristic of bone syphilis (Axhausen 4; Michaelis 41; Weber 75 ; Regöly-Mérei 49, and is detected under the polarization microscope. Opinions had been voiced (11, 75) according to which in the case of bone syphilis, owing to bone decay and apposition, Axhausen's. Grenzstränge originate in every case. Hence, I examined the bones from this aspect too, but could not detect any Grenzstänge even in a single case (Fig. 7). Palaeopathological diagnosis : On the Illrd and IVth plus another precisely not identifiable metacarpus bone symptoms of subacute osteomyelitis. Palaeopathological changes on the right shoulder-blade and on the left ribs pointing to an abscess. Spondylosis. Bone symptoms of pachymengiosis. On the lower third of the right humerus healed spiral fracture with good callus formation. Medium grade abrasion of teeth. Caries on the lower right 6th and upper right 4th teeth. The possibility of bone syphilis is to be definitely excluded on the basis of palaeopathological, palaeohistological and X-ray examinations.