Osteoporosis

“ This year we again set aside a week to mark our concern over osteoporosis. This bone-weakening disease is the most common cause of bone fractures in the elderly and is a major health problem that afflicts millions of Americans. ”

“ A Complete Osteoporosis Program Remember, exercise is only one part of an osteoporosis prevention or treatment program. Like a diet rich in calcium and vitamin D, exercise helps strengthen bones at any age. But proper exercise and diet may not be enough to stop bone loss caused by medical conditions, menopause, or lifestyle choices such as tobacco use and excessive alcohol consumption. It is important to speak with your doctor about your bone health. ”

“ One cannot survey the various diseases of the bones—scurvy, rickets, osteoporosis, osteogenesis imperfecta, osteomalacia, etc.,—without realizing that this group is at present in a state of great confusion and will have to be rearranged and winnowed. The differentiation between some of these diseases is not in every instance clear morphologically—for instance, early cases of scurvy and osteoporosis—so that it is difficult to consider them satisfactorily from the standpoint of pathogenesis. Clinical differentiation is still more difficult and uncertain. ”

“ New research findings and new approaches to prevention, diagnosis, and treatment are being developed to eliminate osteoporosis as a cause of human suffering. Working together, the Federal government and private voluntary organizations have developed a strong and enduring partnership in osteoporosis research. ”

“ The lateral aspect of the clavicle is prone to osteoporosis and is consistent with other bones containing a neural crest component (skull vault) being resistant to osteoporosis.
In conclusion, this study shows that genes associated with bone mass and mineral density are differentially expressed in functionally distinct skeletal sites. Our observations also demonstrate developmental gene expression-based “positional identity” in the adult skeleton. ”

“ Researchers have used a combination of mouse breeding and genetic technology to identify a gene that strongly influences peak bone mass in mice. The gene, which is present in humans as well as mice, was not previously known to be involved in bone biology, and hence represents a promising new target for development of drugs that could prevent or reverse the bone loss that leads to osteoporosis. Peak bone mass, acquired early in life, is thought to be an important factor in the risk for osteoporosis in humans. ”

“ The term rarefying ostitis is applied to any process that is attended with excessive absorption of the framework of a bone, whereby it becomes more porous or spongy than it was before, a condition known as osteoporosis. ”

“ On the other hand, the occurrence of osteomalacia on old, worn-out soil, or on land deficient in lime salts, or from eating feed lacking in these bone-forming substances, or drinking water with a lime deficiency, is in perfect accord with our knowledge of the disease. But osteoporosis may occur on rich, fertile soil, in the most hygienic stables, and in animals receiving the best of care and of bone-forming feeds with a proper amount of mineral salts in the drinking water. ”

“ Let us assume that the requirements of calcium metabolism affect the mass of bone that is selected for, but do not grossly affect the morphology of the bones of that mass. Then selection operates to meet the needs for support within the limits that are set by the necessity to provide the protection for vital organs. After the needs for protection are satisfied, the remaining variable and the one most effective in determining the morphology of bones is selection for increased efficiency in meeting stress. ”

“ It begins at the lower end of the breast-bone and crosses to ribs back and down, in a slanting direction to the third or fourth lumbar vertebra. Like an apron, it holds all that is above it up, such as heart and lungs, and is the fence that divides the organs of the abdomen from the chest. Below it are the stomach, bowels, liver, spleen, kidneys, pancreas, womb, bladder; also the great system of lymphatics of the whole blood and nerve supply of the organs and systems of nutrition and life supply. All parts of the body have a direct or indirect connection with this great separating muscle. ”

“ If the bone is not diseased, but is denuded of flesh all around, it is to be sawn in the same manner, for bones which are disengaged from the other parts all around cannot possibly incarnate. In like manner, the extremity of a bone near a joint, if diseased, is to be sawn off; and often, if the whole of a bone, such as the ulna, radius, tibia, or the like, be diseased, it is to be taken out entire. But if the head of the thigh-bone, or pelvis, or a vertebra of the spine be diseased, we must not attempt to operate upon them for fear of the adjoining arteries. ”

“ Where there are two parallel bones--as in the leg, for example--the growth of the diseased bone may be impaired, and the other continuing its normal growth becomes disproportionately long; less frequently the growth of the diseased bone is exaggerated, and it becomes the longer of the two. In either case, the longer bone becomes curved. An _obliquity_ of the bone may result when one half of the epiphysial cartilage is destroyed and the other half continues to form bone, giving rise to such deformities as knock-knee and club-hand. ”

“ The elements which bear no direct relation to the force production of the body, but which enter into tissue formation, are chlorine, sulphur, iron, sodium, potassium, phosphorus, calcium and magnesium. Bone tissue contains about 50 per cent. of lime phosphate, hence the need of this substance in the food of a growing infant, in order that the bones may become firm and strong. Lack of iron salts in the food impoverishes the coloring matter of the red blood corpuscles on which they depend for their power of carrying oxygen to the tissues; anæmia and other disorders of deficient oxidation result. ”

“ 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 ”

“ Such is not my object, but to place the Osteopath's eye of reason on the hunt of the great whys that the knife is useful at all, I am sure it comes often to remove growths and diseased flesh and bone that have [Pg 155] gotten so by man's ignorance of a few great truths. 1st, If blood is allowed to be taken to a gland or organ, and not taken away in due time the accumulation will become bulky enough to stop the excretory nerves and cause local paralysis; then the nutrient nerves proceed to construct tumors, and on and on until there is no relief but the knife or death. ”

“ Abstract The incidence of limb bone fracture and subsequent morbidity and mortality due to excessive bone loss is increasing in the progressively ageing populations of both men and women. In contrast to bone loss in the weight-bearing limb, bone mass in the protective skull vault is maintained. One explanation for this could be anatomically diverse bone matrix characteristics generated by heterogeneous osteoblast populations. We have tested the hypothesis that adult bones demonstrate site-specific characteristics, and report differences at the organ, cell and transcriptome levels. ”

“ Lining the medullary and cancellous cavities is a delicate connective tissue lining, the endosteum, which contains many bone-forming cells, while on the outside of the bone, except at the articular ends, is the periosteum with its outer protective layer and its inner vascular layer containing osteoblasts or bone-forming cells. The periosteum is essential for the growth of new bone where the old bone has died, and if the periosteum is removed from healthy bone the part beneath is liable to die, as it is by the constant growth of the osteoblasts that the bone grows and is renewed. ”

“ Such supply of fresh air is of vital importance, and the want of it is frequently the sole cause of disease.
In other cases it is not the bones which are soft, but the muscles and ligaments which hold the spine in a proper position are defective. Where the bone is felt to be good-sized and hard, and the surrounding substance too soft, it is a case of this kind. To proper nourishment, in this case, must be added proper exercise of the muscles concerned. Immovable plaster jackets are bad, because they forbid this. This exercise may best be given by rubbing (see Exercise and Massage) . ”

“ In a work of this limited size the sensibility of the various tissues cannot be fully treated but it should be borne in mind that the integument and the subcutaneous tissue, fat and muscles as well as the tendons, their sheaths, the muscles and periosteum and perichondrium covering the bones and cartilages throughout the body, are all highly sensitive to pain. It is also equally true that the bone substance, the bone marrow, and the cartilages are devoid of any of the four modalities of sensation. ”

“ Lime enters largely into the formation of bone, either as a phosphate or a carbonate, and is required in much greater quantities in early life, while the bone is undergoing development, than afterwards. In childhood the bones are composed largely of animal matter, being pliable and easily moulded. For this reason the limbs of young children bend under the weight of their bodies, and unless care is taken they become bow-legged and distorted. Whenever there is a continued deficiency of the earthy constituents, disease of the bones ensues. ”

“ Glycosaminoglycan (Gag) concentrations are higher in limb bone. Osteocyte density in the limb bone was decreased in OVX animals, which is consistent with OVX-induced decreases in other non-cranial skeletal sites [26] . However, the osteocyte density in skull bone was unaffected during growth in an ovarian estrogen-depleted animal. This is consistent with differential responses of regional skull and limb osteoblasts and the pattern of bone loss induced by menopausal hormonal changes. However, we can not preclude that any decrease is partly in response to ageing [27] . ”

“ A very tough skin—a sheathe—surrounds the neck with blood vessels, nerves, muscles, bones, ligaments, fascia, glands great and small, throat and trachea. In bones we find a great canal for spinal cord. It is well and powerfully protected by a strong wall of bone, so no outer pressure can obstruct the flow of passing fluids, to keep vitality supplied by brain forces, but with all the guards given to protect the cord, we find that it can be overcome by impact fluids to such degree as to stop blood and other fluids from supplying lungs and all below. ”

“ The bones have more diseases than the muscles, but really comparatively few, considering their great number and size, and the constant strain to which they are subjected in supporting the body, and driving it forward and doing its work under the handling and leverage of the muscles. Most of their diseases are, like those of the muscles, the after-effects of general diseases, particularly the infections and fevers, which begin elsewhere in the body; and the best treatment of such bone diseases is the cure and removal of the disease that caused them. ”

“ 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. ”

“ In cases of combined endosteal and periosteal thickening, the pain usually disappears under anti-syphilitic treatment but the changes in the bone persist.
Osteomalacia is an acquired disease which causes marked softening and changes in the bones. The disease begins irregularly and often progresses with or without remissions. The progress is more marked during pregnancy. The first sign is pain in the bones, which is increased by pressure, and this is especially true of pressure over the ribs. There are also muscular cramps and contractures.
Osteitis Deformans. ”

“ Illustrations are furnished of the first of these conditions by the high development of muscular tissue under habitual active exercise; of the second in the case of obesity, which is an hypertrophy of the fatty tissues, the elements of which are furnished by the blood; and of the third in the occasional overgrowth of hair in the neighbourhood of parts which are the seat of inflammation. Obviously therefore, in many instances, hypertrophy cannot be regarded as a deviation from health, but rather on the contrary as indicative of a high degree of nutrition and physical power. ”

“ An excess of fat in the body imparts an oily gloss to the skin. The sides of the abdomen are increased in bulk, and the body emits a fetid smell, and the person is assailed with cough and dyspnoea. An excessive formation of bone (abnormal ossification) is attended with such symptoms as the cutting of additional teeth and the abnormal development of any of the bone-structures. An excessive formation of marrow gives rise to a heaviness of the eyes and to the members of the body. ”