§ 206. Ostitis, inflammation of bones.

The vessels of bones and the periosteum are frequently found inflamed. The pain is most violent when the marrow is inflamed, less in periostitis, and still less in ostitis.

It is sometimes easy and at other times difficult to diagnose ostitis; in diagnosing that disease, we have to consider the scrofulous and syphilitic diathesis. Some bones are more liable to inflammation than others. The symptoms of ostitis are: heat, which is even felt externally; redness, not only of the bones but also of the periosteum and the external integuments; swelling and softening of the inflamed bone, most distinct in the epiphyses of bones. This swelling develops itself slowly, the bone becomes spongy, porous, extremely sensitive, and loses its specific gravity. The pain is rather dull, boring, more violent at night than in the day time, particularly when the inflammation is of a syphilitic nature, or arises from mercurial poisoning. The bone becomes curved, the muscular action preponderates, whence deformities ensue. The fever is not very violent, but exacerbates in the evening and at night.

§ 207. The course, duration, and classification of ostitis vary considerably, according as the disease arises from one or the other cause. The fever is generally erethic, except in the case of young subjects, where the fever is frequently a synocha.

Ostitis is generally cured under homoeopathic treatment; it may, however, terminate unfavourably:

(1.) In suppuration of the bone. The pus is a reddish, fetid fluid. The suppuration generally takes place superficially, the periosteum is destroyed, the bone becomes rough and porous. If the suppuration should be more deep-seated, the pus is more coloured and fetid. The inflammatory symptoms disappear gradually, the bone swells up more and more, parts become detached, causing external suppuration. If the suppuration should continue for a time, it sometimes terminates in humid caries.

(2.) In induration. This termination is more frequent in chronic than in acute inflammations, particularly when the patient is weakly and has a torpid, scrofulous constitution. The bone becomes unusually hard, raised, (tophus,) changes to a porous, spongy mass, which is liable to renewed inflammations.

(3.) In softening, (osteosarcoma,) terminating sooner or later in induration.

(4.) Anchylosis; this occurs most frequently in the joints, elbow, knee, carpal and tarsal joints.

(5.) Osteonecrosis; when this condition sets in, the acute pains cease, the inflammatory symptoms abate, the diseased portion of bone gradually separates from the sound bone, in which suppuration gradually sets in, by means of which the last portion is sometimes restored. This termination is most frequent in the long bones, particularly on their surface.

Children and adults are more liable to ostitis than old people, particularly when born of scrofulous or syphilitic parents. Bones which have been once inflamed are exposed to a renewed attack of inflammation.

Simple ostitis is not incurable. Ostitis complicated with some general dyscrasia, or with a mercurial or psoric diathesis, is much more difficult to cure.

§ 208. Aconite will be found necessary in a few cases only, particularly when the inflammation was caused by fracture, contusion, etc. In most cases, the inflammation is a mere symptom of some more general disease, and will yield to the remedies indicated for the latter.

In slight cases, when the inflammation is not yet far advanced, and the skin is simply red, with slight swelling of the bone, and sensitiveness to contact, Bryon. and Puls, will be found suitable A much more useful remedy in ostitis is Mercurius, except when the inflammation was caused by the excessive use of that poison, in which case Puls., China, Hep. sulp., Sulph., Electricity; or, when the inflammation has an erysipelatous character, Bellad. will prove beneficial. Specific remedies for ostitis, including mercurial and syphilitic, are: Daphne Mez., Asa foetida, Staphysag., Aurum, Mangan. acet., Acid, phosphor., Sulph., Silic, Calc. carb., Lycop., Nitr. ac, Sepia, Baryta, etc. Mangan. acet. is less useful in inflammation of the bone itself, than in periostitis and inflammation of the joints with intolerable pains. In inflammation of the facial bones, Mercur., Staphys., and Aurum are particularly useful. Merc, and Staphys. are likewise useful in inflammation of the iliac bones. Asa and Mezer. are more especially indicated in inflammation of the superficial bones. Mezer. is particularly useful in periostitis, which may be discovered from the fact that the adjoining soft parts are likewise more or less inflamed. Acid, phosph., Asa, Mez., Merc, Sil., and the other above-named remedies, are excellent for caries and ulcers of bones, even when caused by the excessive use of Mercury. All these remedies may likewise be employed with advantage for the chronic disorganizations resulting from ostitis. Carb. veg. should be mentioned for a burning pain in the bones; Phosphorus is likewise excellent.