404 Diseases of Bone. 



bone, and seemed to arise from the substance of the bone. ' ' The wound 

 healed." 



The substance of the bone is firm and somewhat fibrous, 

 Avith an intermingling of spicules of bone. G. C. 1272. 



Fresented by Joseph Bell, F.R.C.S.E. 



6. 494. Sarcoma of the Antrum of Highmore. — Portion of 



a large sarcoma, laid open — in spirit, illustrating the above. 



The following is an excerpt from a " clinical lecture on the case 

 of Hugh Morrison, aged 51, delivered by Sir George Ballingall to the 

 students of Surgery in the Royal Infirmary, Edinburgh, at the conclusion 

 of the summer course for 1827." 



" Four months ago (before admission to Infirmary), after exposure 

 to cold, he was affected witli pain in the molars. One of them was- 

 extracted with a little relief, the alveolus was punctured, and about a gill 

 of clotted blood evacuated. Complaint is attended with gnawing, lan- 

 cinating pain, which becomes worse in the night, and he is much subject 

 to headache. General health good. 



"There is an extensive tumour in the region of the superior right 

 maxillary and malar bones, bounded above by the tarsal edge of the lower 

 eyelid, by the extremity of the nasal process of the superior maxillary 

 bone, and by the external angle of the frontal bone. Inferiorly, it extends- 

 to below the level of the teeth of the upper jaw ; posteriorly, it is bounded 

 by the zygomatic process and by the anterior edge of the ramus of the 

 lower jaw : internally it has driven the inner wall of the antrum into the 

 nostril, so that a probe is not easily passed through the inferior meatus ; 

 the palatine process of the superior maxilla is softened, and also very much 

 inclined inwards. Two of the bicuspid teeth are quite loose ; the remain- 

 der of the teeth placed behind the above have been removed. Two or 

 three glands upon the parotid are enlarged. The surface of the swelling 

 is irregular — in some places soft, in others hard and cartilaginous. Vision, 

 hearing, and smell on the aff'ected side are all impaired ; the eye, however, 

 is not protruded from the socket ; deglutition is attended with some 

 difficulty." 



The tumour was removed with considerable loss of blood ; but the 

 patient recovered from the operation. 



The disease, however, returned, and on March 28th Mr Macpherson, 

 his medical attendant at home, described " the appearance of the tumour 

 to be truly appalling ; nearly the whole surface being in a state of active 

 ulceration and occasional discharges of blood from the ulcerated vessels. 

 The patient's appetite had completely failed. He was harassed with 

 diarrhcea, and could not be expected to survive many days." 



The surface of the tumour is smooth at one part and warty 



