CANCER OF THE SPINE. 511 



third, which is the one with extreme disease of the body, the bone 

 structure at the base of the spinous process bulges considerably on 

 either side. On cutting into this, on the left, is a clear, semi-trans- 

 parent, bluish-gray deposit, of gelatinous consistence, with no evidence 

 whatever of inflammatory action around, but clearly malignant in its 

 nature, and surrounded by expanded bones, which has made way for 

 the morbid product. The spine of the fourth vertebra is similarly 

 affected, but to a greater extent. The transverse processes have been 

 equally invaded. The second one presents, on its superior surface, 

 towards its attached end, a circular aperture, with tolerably denned 

 margin, communicating with a cavity filled with malignant deposit, and 

 circumscribed by the expanded layers of the bony process. The last 

 two of the spinous processes are much more diseased, the rarefaction of 

 bone is greater, the destruction more advanced, and a jagged erosion, 

 about an inch long, and more than half an inch in extreme breadth, 

 indicates where the cerebriform deposit has spread its ravages rapidly 

 and with effect. On the right side it is only the transverse process of 

 the last lumbar spine, with the corresponding portions of the sacrum 

 sawn off with it, that give evidence of diseased action. The bone, greatly 

 rarefied and swollen, though looking solid throughout, when cut across is 

 found to contain an irregular deposit of yellowish-grey colour and gela- 

 tinous firmness, which has led to a considerable excavation of the bone. 

 " On cutting through the arches of the spine on the left side, then per- 

 pendicularly through the bodies from below, the spinal canal is exposed 

 without being injured, and the progress of the disease can be readily 

 studied. In the centre of the cancellous tissue of the bodies of the last 

 two vertebrae is a cancerous deposit, most extensive in the very last bone. 

 It is seen in the form of perfectly circumscribed masses, which we must 

 attribute to the colloid variety, from its transparency, uniform gela- 

 tinous consistency, and scantiness of cells. Not so, however, with the 

 large pulpy masses, infiltrating and destroying almost entirely the 

 second and third lumbar spines ; this is distinctly encephaloid, of appa- 

 rently rapid formation, deeply tinged, of a brownish red in parts, or else 

 of a yellowish or greyish red in others. The bone around, the solidity 

 of which has given way to malignant disease, gives no evidence of in- 

 flammatory action, or any reparative process ; it has yielded to the 

 encroaching deposit, "which has forced two open passages into the spina 

 canal. Here blood has been extravasated outside the dura mater 

 pressing, as well as the carcinomatous mass, on several of the organs of 



