400 Diseases of Bone. 



myeloid sarcomatous tumour, which grew from the symphysis of 

 the lower jaw of a boy — in spirit. 



William D., aged 10, was admitted into the Royal Infirmary, 

 Edinburgh, on 23rd July 1890. 



About three months ago patient noticed a small lump growing on 

 his gum. The patient had some bad teeth extracted, •nhich were supposed 

 to have caused the swelling. He thinks it was less for a time, but shortly 

 afterwards began to enlarge rapidly. Since that time it has remained 

 much the same as it is now. 



Growing from the inferior maxilla, in the position of the two middle 

 and left lateral incisor teeth, there was a rounded swelling projecting into the 

 mouth, and dusky red in colour, except at the top, where it was pigmented. 

 It was soft to the touch and bled easily. After the patient had been in 

 Hospital for some time the swelling became firmer. He felt no pain from 

 it, but could not masticate his food properly, and his mouth had a nasty 

 taste and a fcetid odour. 



The general health and family history are good. 



On 12th August 1890 the patient was put under chloroform, and 

 Mr Cathcart freely excised the tumour, with the adjacent bone, and 

 removed one or two large glands below the angle of the jaw. 



In August 1892 the boy was brought to the Infirmary to report 

 himself. There was no return of the tumour, and he was in good health. 

 There were some slight enlargements of the lymphatic glands below the 

 lower jaw, but they were in all probability not connected with the tumour. 



The section of the tumour shows that it has grown out 

 from the centre, and has caused absorption of the greater part 

 of the bone, except along the lower border. G. C. 3207. 



6. 485. Myeloid Sarcoma of the Lower Jaw.— Left and part 



of right half of the body of the lower jaw of a young woman — 

 in spirit, illustrating the above. 



Janet E., aged about 25, had noticed, three or four months 

 before admission to the Royal Infirmary, Edinburgh, a swelling on lier 

 lower jaw. It caused no pain, but she had one or two teeth removed, 

 as they were supposed to be the cause of the growth. The growth 

 increased, and she came for advice to Dr Joseph Bell, who removed the 

 tumour and lower jaw. The patient made a complete recovery, and now, 

 six years afterwards, she remains in perfect health. — (C. W. C, 1893). 



The bone towards the angle has been almost entirely 

 replaced by the tumour, which has, moreover, projected exten- 

 sively beyond it, towards both the mouth and the cheek. 



