198 ■ Diseases of Bone. 



"Though prepared for something very extraordinary, I certainly 

 was astonished at first sight of the patient. 



"The mouth was placed diagonally across the face, and had suffered 

 such a monstrous distension as to measure 15 inches in circumference. 

 The throat of the patient was almost obliterated in appearance, there 

 being only about two inches of it visible above the sternum, so that the 

 cricoid cartilage of the larynx was on a level with that bone. When the 

 tumour was viewed in profile, it extended eight inches from the front of 

 the neck. It completely filled the mouth, and occupied all the space below 

 it from jaw to jaw. The tongue was thrust out of its place, and lay 

 between the teeth and cheek of the right side. The only portion of the 

 jaw not implicated in the disease was the right ramus and base of the same 

 side, from the bicuspid teeth backwards. The tumour, where covered by 

 the integuments, was uniformly very firm, and for the most part 

 distinctly osseous. The part which appeared through the mouth was a 

 florid, irregular, fungous-looking mass of firm consistence, from which an 

 alarming hemorrhage had occasionall)', and for the last three or four weeks 

 there had been almost daily a discharge of blood to the extent of one or two 

 ounces. Notwithstanding the great bulk of the tumour, the patient could 

 move his jaw pretty freely in all directions. With the exception of the 

 disease now described, Penman enjoyed good health. He was a tall, well- 

 made, though much emaciated, intelligent young man, and possessed 

 uncommon fortitude." The tumour, along with more than half the lower 

 jaw, was removed by Mr Sj^me on 7th July 1828, and the patient made a 

 good recovery. 



In 1848 Mr Syme added to the above: — "About two years ago, 

 and consequently seventeen years after this operation, I was stopped in the 

 street by a well-dressed, respectable-looking man, who introduced him- 

 self as Penman. He told me that after working for several j'ears at 

 home as a bootmaker, he had gone in quest of better wages to New York ; 

 that he had spent ten years in America, whence he had just arrived ; and 

 that he proposed to return there after a short visit to his native country. 

 I was no less surprised than pleased to see how little the operation had 

 injured either his appearance or articulation. Careful inspection, indeed, 

 was required to enable an ordinary observer to detect anything peculiar in 

 either of these respects." 



(Syine's " Contributions to the Pathology and Practice of Surgery," 

 p. 13. 1848.) 



G. C. 1185. 



Presented by David R. Dobie, M.D. 



6. 480. Ossifying" Sapcoma of the Lower Jaw.— Right half of 



the body of a lower jaw — in spirit, illustrating the above. 



The greater part of the lower border of the bone is replaced 

 by a sarcomatous tumour, which extends laterally on both aspects. 



