Bone tool

“ They exhibit a rough symmetry; they rarely attain any size; and they usually cease growing when the skeleton attains maturity—the conversion of cartilage into bone being then completed. While they originate from the ossifying junctions of the long bones, they tend, as the shaft increases in length, to project from the surface of the bone at some distance from the ossifying junction and to “point” away from it. They may cause symptoms by “locking” the adjacent joint or by pressing upon nerve-trunks or blood vessels. ”

“ The interment consisted of a quantity of calcined human bones, which lay upon a thin layer of earth at the bottom of the hole, as compactly as if they had at first been deposited within a shallow basket or similar perishable vessel. Upon them lay some fragments of iron, part of two bone combs, and twenty-eight convex objects of bone, like button-moulds.
“The pieces of iron have been attached to some article of perishable material; the largest fragment has a good-sized loop, as if for suspension. ”

“ If, on the contrary, there is much displacement, and if that is not entirely removed, intense action ensues both in the soft and hard parts, there is great effusion of new matter, or callus, soft and yielding at first, but gradually becoming hard and dense—bony particles being deposited from the vessels ramifying in the extremities, or in the attached fragments, of the old bone. When detached portions of callus are found lying in the soft parts, a piece of old bone which retained its vitality has generally formed the matrix of the deposit. ”

“ The shaft of the arm-bone continues to increase in length till the twenty-fifth year of life; and so long as this change continues, a portion of soft vesicular and growing tissue intervenes between the shaft and the head of the bone. It is not till about the twentieth year of life that this soft substance is converted into bone, and the principal bone of the arm becomes consolidated. The lower end of the bone of the fore-arm, to which the hand is mainly fixed at the wrist-joint, is also at the age of eighteen still incomplete, but it is finished at about twenty years of age. ”

“ With a small sharp knife make an incision in the thin skin between the inside of the legs and the body. Cut through the skin only, down toward the right side of the leg, and then on the left. Bend the leg over toward you, and you will see where the flesh joins the body and also where the joint is, for the bone will move in the joint. Cut through the flesh close to the body, first on the right of the joint and then on the left, and as you bend the leg over, cut the cord and gristle in the joint, and this will free the leg from the body. ”

“ A bone would become a muscle, if, without changing its texture at all, nature had imparted to it the faculty of secreting fibrin, and of encrusting itself with it, instead of separating the phosphate of lime and being penetrated with it. But the serous system does not appear to have in it a distinct nutritive matter, and consequently a peculiar texture. ”

“ By employing a small saw—represented in both ancient and modern surgical works—so as to widen the fracture, or remove a projecting corner of bone, sufficient room may be obtained for the introduction of the lever and the removal of splinters. In old subjects, the bones are brittle, and a small corner may be readily removed by pliers, or cutting forceps, so as to allow the depression to be raised. ”

“ The broken extremities of the bones become intimately united by bony matter passing from one to the other. The mass of new bone on the outside, formed by the ossification of the callus, being no longer wanted, is absorbed; by degrees the whole of it disappears, and the bone is left having the same dimensions which it had before the occurrence of the accident.
The process of union is completed in young persons sooner than in those advanced in life; in the upper extremities sooner than in the lower; and in smaller animals more speedily than in man. ”

“ A long bone consists of a shaft and two extremities. The shaft is a hollow cylinder within which is the medullary canal. The extremities are somewhat expanded for the purpose of articulation, and to afford a broad surface for the attachment of muscles. The long bones are as a rule curved in two directions to give greater strength to the bone. Some examples of this class of bone are the clavicle, radius, ulna, humerus, femur, tibia, fibula, metacarpal, metatarsal, and the phalanges. ”

“ Finally, this red zone was covered with a fairly thick layer of 42 white bone: this was the layer formed after the madder had been left off.... We shall have no further difficulty in understanding whence transudes the osseous juice that was thought necessary for the formation of callus and the filling-up of the wounds of the bones, now we see that it is the periosteum that fills up the wounds, or is made thick round the fractures, and afterward becomes of the consistence of cartilage, and at last acquires the hardness of bones. ”

“ The FEMUR is the longest bone in the system. It supports the weight of the head, trunk, and upper extremities. The large, round head of this bone is placed in the acetabulum. This articulation is a perfect specimen of the ball and socket joint.
107. The PATELLA is a small bone connected with the tibia by a strong ligament. The tendon of the ex-tens ́or muscles of the leg is attached to its upper edge. This bone is placed on the anterior part of the lower extremity of the femur, and acts like a pulley, in the extension of the limb. ”

“ The general form of a long bone is that of a shaft, having an enlargement at either extremity, the shaft is generally curved slightly so as to give elasticity, and is more solid than the ends, which are expanded to give size and firmness to the joints, and porous to keep them light; the shaft is small and close in its texture, that there may be plenty of room for the muscles which lie on and cover it. The skeleton then, consists of bony cases which enclose the viscera, a series of levers covered with, and moved by the muscles, and the whole forming a solid framework to support the soft parts. ”

“ And this may possibly be the reason why the bones of the skull, though not exposed to forces such as those which produce, in other bones, dense outer layers including less dense interiors, nevertheless repeat this general trait of bony structure. While, however, it is beyond doubt that some bones are not due to the direct influence of mechanical stress, we may, I think, conclude that mechanical stress initiates bone-formation. ”

“ If any osseous deposit has taken place, it is absorbed; the ends of the bone are diminished in size by interstitial absorption; ligamentous or fibro-cartilaginous tissue is formed round the wasted extremities; and the surrounding cellular tissue being thickened and condensed, a sort of synovial pouch is formed, in which the ends, by this time smooth and rounded off, move freely. The limb is shortened in some degree, and its actions are very much diminished in force, there being no sufficient support for the muscles. ”

“ The lower part of the femur, (thigh-bone,) and upper part of the tibia, (leg-bone,) are seen ossified at 1, 1. The cartilaginous extremities of the two bones are seen at d, d. The points of ossification of the extremities, are seen at 2, 2. The patella, or knee-pan, is seen at c. 3, A point, or centre of ossification.
73. The PERIOSTEUM is a firm membrane immediately investing the bones, except where they are tipped with cartilage, and the crowns of the teeth, which are protected by enamel. This membrane has minute nerves, and when healthy, possesses 32 but little sensibility. ”

“ While the knife is between the bones, its edge may be so turned that the membrane may be divided longitudinally to any convenient extent for the easy introduction of a retractor, and the soft parts around the bone nearest to the operator may subsequently be divided by a sweep of the knife in a manner similar to that adopted for the division of parts around the more distant bone. ”

“ The pliers should be strong in every point, and the handles long, to afford the advantage of a powerful lever. In edentulous subjects, as the one alluded to above, there is no necessity for using the saw at all: the bone is at once and easily cut by the forceps. The chain saw has been recommended for performing the section of the bone, but I have not yet seen one to be depended on; it is not only slow, but uncertain, in its operation. ”

“ 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. ”

“ Besides the general arrangement of the parts of the skeleton, there is such a grouping of the bones in each of its main divisions as will enable them to serve definite purposes. In most places they form mechanical devices for supplying special movements, and in certain places they provide for the support or protection of important organs. In most cases there is a definite combination of different bones, forming what is called the bone group. ”

“ If the impaction take place owing to the head being larger than natural, if it be a hydrocephalous fœtus, we must open its skull with a polypus-scalpel, or a needle, or a sharp-pointed knife concealed between the fingers, in order that it may collapse when evacuated; but if it be a naturally large head, we must open the skull in like manner, and break down its bones with a tooth-forceps or a bone-forceps, and if the bones project they ought to be extracted. ”

“ Abundant cartilage cells in a matrix containing many branching elastic fibres. Bone.—Bone is a connective tissue in which a considerable amount of mineral matter is deposited in the intercellular matrix whereby it acquires a dense and rigid consistency. If bone be incinerated so that the organic matter is burnt away, a residue of mineral matter is left. This consists chiefly of calcium phosphate, and amounts to as much as two-thirds of the weight of the original bone. ”

“ If any bones have been broken, they must now be repaired, either by gluing them together, or by joining with a short wire fitted into the axis of each piece, and the missing particles of bone may be restored by a filling of best sinew glue mixed with plaster Paris into a paste, and applied hot, so that it will adhere. As it cools it can be shaped properly, and when thoroughly dry and hard, its surface must be dressed down with a fine file and sand-paper until the form of the bone is once more perfect. ”

“ Numbers of bone ligulae were found in a Roman hospital lately excavated at Baden.
In the Naples Museum there are two ointment spoons with carved bone handles. Needles such as Hippocrates and Celsus speak of for stitching bandages to fix them were very frequently made of bone and ivory. Knife handles of bone and ivory are common. A carved ivory medicament box with sliding lid will be fully described later. Scribonius Largus describes knives of bone and ivory for preparing plants for pharmaceutical purposes (Compositiones, lxxxiii) . ”

“ The first flap is made posteriorly to the bone, by transfixing the limb, for which purpose the knife is entered at the mid-point between the anterior and posterior surfaces, carried transversely across the limb, and made to cut toward the posterior surface, in an oblique direction, until all the soft structures are divided. It is necessary, in entering the knife, to bear in mind that the bone lies opposite to the mid-point, and that, in carrying the knife across the limb, it would strike against the surface of the bone, unless means were adopted for its prevention. ”

“ The bone department is where the bones are cared for and prepared for commercial purposes. Nearly all bones that are of value, to be sold as such, come from cattle, and to this department is sent the horns, skulls, jaws, feet, shank bones, thigh bones, blade bones, rib bones and those resulting from cutting and boning cattle. These yield what is known as manufacturing bone, such as shins, blades, buttocks and thigh bones. Most of the balance is used for bone fertilizer, glue and grinding. The bone usually produced in the bone department is hard bone. ”

“ Let us now come, at last, to the mechanical structure of bone, of which we find a well-known and classical illustration in the various bones of the human leg. In the case of the tibia, the bone is somewhat widened out above, and its hollow shaft is capped by an almost flattened roof, on which the weight of the body directly rest. ”

“ The words “quite ready” are no sooner whispered, than the operator, grasping firmly with his left hand the flesh which forms the front part of the patient’s thigh, thrusts quietly and deliberately the sharp blade horizontally through the limb, from its outer to its inner side, so that the thigh is transfixed a little above its central axis, and in front of the bone. He next cuts directly downwards, in the plane of the limb, for about four inches, and then obliquely outwards, so as to form a flap, which is seized and turned upwards out of the way by the appointed assistant. ”

“ We are not less interested in tracing the formation of bone through its several stages, than in considering other parts of the human system. The formation of the Haversian canals for the passage of blood-vessels to nourish the bones, the earlier construction of bony tissue by a metamorphosis of cartilaginous substance, and also the commencement of ossification at distinct points, called centers of ossification, are all important subjects, requiring the student's careful attention. ”