EXPERIMENTAL SYPHILIS IN THE RABBIT : VI. AFFECTIONS OF BONE, CARTILAGE, TENDONS, AND SYNOVIAL MEMBRANES. PART 3. SYPHILIS OF THE POSTERIOR EXTREMITIES WITH OTHER AFFECTIONS OF A MISCELLANEOUS TYPE.

A systematic study was made of the affections of bone, cartilage, tendons, and synovial membranes which occurred in a series of rabbits with generalized syphilis. Localized infection of this group of structures was found to be of very frequent occurrence. The parts involved were, in the order of their frequency, the facial and cranial bones and cartilages, the bones, tendons, and joints of the feet and legs, the cervical and caudal vertebræ, the ribs, and the sternum. These infections often gave rise to characteristic manifestations of disease which could be detected without difficulty by inspection or palpation of the part. In many instances, however, clinical manifestations were so slight that the presence of lesions could be detected only by radiographic or pathological examination. Detailed descriptions of various clinical types of disease were given and the clinical manifestations correlated with the pathological process. It was pointed out that bone lesions exhibited a decided predilection for certain exposed bony prominences, for lines of bony union, and for epiphyseal lines in particular. A study of the clinical history of bone lesions brought out the fact that they were among the earliest of the generalized forms of disease; they tended to pursue a comparatively rapid course, and relapse was never observed. Especial emphasis was laid upon three aspects of the experimental infection: the analogy existing between certain forms of the animal and human affections, the relation of syphilis of the osseous system to other evidences of disease, and the occurrence of obscure bone lesions. In this connection, it was pointed out that the nasal and epiphyseal lesions of the rabbit presented a striking analogy to those of congenital syphilis in man. It was also pointed out that syphilis of the osseous system occupied a definite position in the scheme of defensive reactions such that lesions of these tissues might be favored or inhibited according to the experimental conditions employed. Finally, the frequency with which infections occurred which were not accompanied by sufficiently distinctive signs even to suggest the possibility of their existence was interpreted as evidence that some cases of latent or obscure infection in man might find their explanation in the presence of a similar group of affections.