Cancers invading Bone. 393 



only to open again in a similar way after another interval. Three years 

 before admission to the Royal Infirmary, the ulcer had again broken out. 

 Numerous pieces of bone had come away, and the tibia suddenly snapped 

 one day as he was trying to walk. The sore had a most fcetid odour, and 

 was covered by masses of thickened epithelium, with here and there florid 

 gi-anulations which microscopically showed the characters of epithelioma. 

 The tibia, opposite where the ulcer was, is irregularly eroded 

 and destroyed, a result probably due partly to the old-standing 

 osteo-myelitis, as well as partly to the more recent epithelioma. 

 The fibula is greatly thickened near the site of the ulcer, as 

 usually occurs in such cases, but both bones are somewhat 

 lightened in texture, possibly owing to the comparative disuse 

 of the limb. G. C. 2794. b. 



Presented by John DrxcAN, F.R.C.S.E., 1888. 



6. 466. Epithelioma and Chronic Suppuration, eroding- 



and destroying" the Tibia. — Cast in glue and glycerine of 

 the limb in the previous case, after amputation, showing the 

 appearance of the epitheliomatous ulcer. G. C. 2794. 



Presented by Charles W. Cathcart, F.R.C.S.E. 



6. 467. Epithelioma penetrating- and eroding- the Tibia.— 



Lower two-thirds of a left tibia and fibula, soft parts partly 

 removed — in spirit, illustrating the above. 



July 1825. — "The patient, a man, aged 35, reported that the disease 

 commenced 20 years ago after the receipt of a contusion. Five years sub- 

 sequently it healed, and remained so for ten years, when it again made its 

 appearance. It has gradually increased since." 



" On the anterior part of the middle third of the left leg there is a 

 very extensive ulcer of the size of a hand's breadth, which has destroyed 

 not onl}- the integuments but part of the tibia, which is exposed and rough 

 to the extent of an inch. The surface of the ulcer is very uneven ; the 

 granulations and discharge have a verj* unhealthy appearance. The 

 secretion of pus is in large quantity. He complains of much pain, refer- 

 able principally to the bone ; surrounding inflammation considerable 

 (sic). His general health is very good." 



" 1st August. — Mr Allan to-day scraped the surface of the bone, 

 which he found to bs very much diseased. 



