394 Diseases of Bone. 



" 5th. — Mr Allan to-day amputated the leg five inches below the 

 knee, by the circular operation. Nothing uncommon occurred ; and few 

 vessels required to be tied. The patient bore it without expressing much 

 pain. 



" 28th. — Dismissed in progress of cure." 



This specimen shows that the tibia and fibula have been 

 enlarged, as is usual, from their being in the neighbourhood of a 

 chronic ulcer, but the destruction of the tibia is special, and is 

 due to the inroads of epithelioma. G. C. 983. 



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



Lower two-thirds of a left tibia and fibula — macerated, illustrat- 

 ing the above. 



Both bones show the typical enlargement associated with 

 chronic ulceration, with, in addition, an area of destruction on 

 the tibia, doubtless due to epithelioma. This has evidently 

 been a case of chronic ulcer, upon which epithelioma has 

 supervened. W. C. G. 21. 



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



Portion of a tibia — macerated, illustrating the above. 



The substance of the bone is much eroded, at one place 

 almost eaten through, while above and below the deficiency the 

 bone has been thickened. This has apparently been another 

 case of chronic ulcer, followed by epithelioma, which has in- 

 vaded the bone. B. C. i. 5. M. 18. 



6. 470. Epithelioma invading- the Tibia.— Portion of a right 

 leg — in spirit, illustrating the above. 



" The leg was amputated above the knee, but the disease returned 

 in the stump, and the man died. " 



This specimen shows that at some parts the ulcer has had 

 normal granulations, while at others there are great irregularities- 



