( 
Dee. 2, 1870.] 19 i Pepper. 
A CASE 
OF UNIVERSAL HYPEROSTOSIS, ASSOCIATED WITH OSTEO- 
POROSIS, WITH A DESCRIPTION OF THE SPECIMENS, by 
J. Ewine Mears, M. D., W. W. Kenn, M. D., Harrison ALLEN, 
M. D., and WiLt1AM Perper, M. D. 
(Read before the American Philosophieal Society, Dec. 2, 1879.) 
The undersigned, to whom were referred the above specimens, presented 
by a friend to Dr. J. Ewing Mears, have carefully examined them, and 
have prepared the following Report :— 
In the investigation of the subject, we have prepared as full a history 
of the case as could be obtained, a detailed account of the general ana- 
tomical characters of the disease, and of the peculiarities of each individ- 
ual bone, as well as of the microscopic appearances, have consulted the 
works and periodicals in various languages accessible in this city, and 
have examined all the specimens contained in the Museums of the Col- 
lege of Physicians, Academy of Natural Sciences, University of Pennsyl- 
vania, Jefferson Medical College, and also the hospital and private collec- 
tions in the city. 
We have nowhere found specimens of this disease, or descriptions of 
such, at all equalling in extent and severity these here described. 
The only similar case, though far less in degree and extent (skeleton 
imperfect), is found in Virchow’s Archives, Vol. 43, 1868, p. 470, plate 
No. 12, although we have met with specimens and descriptions of skulls 
and bones which afford evidences of a limited development of the same 
disease. 
Of the pathology of the disease, as well as of the anatomical appear- 
ances (116), we have found the best descriptions in Lobstein, Traité 
@anatomie pathologique, Tom. II, p.116; Boyer, Sur les Maladies, 
Chirurgicales, Tom. III, p. 571; Paget, Surg. Path. Eng. Ed., pp. 301-2, 
and fig. 40; Stanley on the Bones; 8. Solly, Med.-Chir. Trans., Vol. 27; 
Férster Handbuch der Path. Anat., Bd. I, S. 249-52, and Bd. II, S. 
850-4; R. Volkmann, in Pitha und Billroth’s Handb. der Chirurgie, Bd. 
IT, 8. 249-58; Oeffinger, Virchow’s Archiv, Bd. 48, 8. 470; Haubner, 
Canstatt’s Jahresbericht, 1854, Bd. 27, 8. 23-4; Virchow, Die Krankhaf- 
ten Geschwiilste, Bd. II, Vorlesung XVII. 
HISTORY OF THE CASE. 
Fully recognizing the importance the history of the case has in the dis- 
cussion of the Etiology and Pathology of the disease, we regret our inabil- 
ity to add any information to the statement given at the time of the 
presentation of the specimens, which is as follows :— 
A. M. aet, 14, native of England—occupation farm boy—came from 
England to this country when very young—father died in November, 
1862, of Phthisis, aged 57—mother died in 1867, cause of death not as- 
certained—has one brother and one sister, both young and healthy. In 
September, 1866, while engaged at work on the farm, noticed swelling 
