thus removed aggregated 11 feet, the
longest piece measuring two feet and the shortest 1/4 inch. The wire
was found imbedded under the muscles of the arm, and some of it had
become wedged between the bones of the forearm. Probably the most
remarkable feature of this curious accident was the fact that there was
no fracture or injury to the bone, and it was thought possible that the
function of the arm would be but little impaired.

Tousey reports a case of foreign body in the axilla that was taken for
a necrotic fragment of the clavicle. The patient was a boy of sixteen,
who climbed up a lamp-post to get a light for his bicycle lamp; his
feet slipped off the ornamental ledge which passed horizontally around
the post about four feet from the ground, and he fell. In the fall a
lead pencil in his waistcoat pocket caught on the ledge and was driven
into the axilla, breaking off out of sight. This was supposed to be a
piece of the clavicle, and was only discovered to be a pencil when it
was removed six weeks after.

There are several diseases of the bone having direct bearing on the
anomalies of the extremities which should have mention here.
Osteomalacia is a disease of the bones in adult life, occurring most
frequently in puerperal women, but also seen in women not in the
puerperal state, and in men. It is characterized by a progressive
softening of the bone-substance, from a gradual absorption of the lime
salts, and gives rise to considerable deformity, and occasionally to
spontaneous fracture.

Rachitis or rickets is not a disease of adult life, but of infancy and
childhood, and never occurs after the age of puberty. It seldom begins
before six months or after three years. There are several theories as
to its causation, one being that it is due to an abnormal development
of acids. There is little doubt that defective nutrition and bad
hygienic surroundings are prominent factors in its production. The
principal pathologic change is seen in the epiphyseal lines of long
bones and beneath the periosteum. Figure 213 shows the appearance
during life of a patient with the highest grade of rachitis, and it can
be easily understood what a barrier to natural child-birth it would
produce. In rachitis epiphyseal swellings are seen at the wrists and
ankle-joints, and in superior cases at the ends of the phalanges of the
fingers and toes. When the shaft of a long bone is affected, not only
deformity, but even fracture may occur.