Tumours of the Lower Jaw. 397 



2. Fibrous and Osseous, from the Periosteum and Bone — ranging 

 from the slowly-groiving simple forms tvhose tissues are 

 well developed to the rajjidly -growing malig7iant forms 

 whose tissues are more or less emhryonic. 



6. 478. Exostosis of the Lower Jaw.— Portions of an osseous 

 tumour, covered -witli warty growth, removed from the gum of 

 a lower jaw — in spirit. 



The bone is well formed, and the tumour has evidently been 

 of slow growth. 



F. P. C. 3005. 



6. 479. Enormous Fibro-osseous Tumour of the Lower 

 Jaw. — Plaster cast of a head and neck, showing an enormous 

 tumour of the lower jaw, successfully removed by Professor 

 Syme. The lines of the incisions used at the operation were 

 marked in when the cast was presented. 



The following note is by Professor Syme: — "Between eight and 

 nine years ago, Robert Penman, from Coldstream, then sixteen years old, 

 noticed a hard swelling of the gum on the outer side of the grinding teeth 

 of the lower jaw. The swelling was not painful, but gradually increased. 

 When it attained the size of an egg he applied to a surgeon of the neigh- 

 bourhood, who extracted three of the adjoining teeth. It then grew more 

 rapidly, and having at length become as large as an orange, induced him 

 to repair to the Royal Infirmary of this city, where it was removed, i.e., 

 cut off from the bone. The wound did not heal, and the actual cautery- 

 was repeatedly applied in vain to make it do so. After remaining eight 

 months in the Infirmary, he returned home ; but finding the tumour 

 rapidly and regularly increasing, he two years afterwards came again to 

 Edinburgh, and consiilted a distinguished operating surgeon (now in 

 London), who declined to make any attempt towards his relief. He went 

 home with the fearful prospect of a certain lingering and painful dissolu- 

 tion ; and it was after three years and a AaZ/' spent in this miserable state 

 that Dr Sibbald of this city happened to see him. Though the tumour 

 was then nearly three times larger than it was when the patient last 

 quitted Edinburgh, Dr Sibbald felt persuaded that it was still within the 

 reach of surgery, and therefcie encouraged the young man to come once 

 more to town, which he accordingly did. 



