9 
1870. ] 27 [Pepper. 
developed osteophytes. A few also exist at the middle of the insertion of 
the trapezius. The section shows the original bone distinct from the 
new growth at all points. The lamine of the new growth are very dis- 
tinct at most points. A large part of those of the under surface are more 
or less closely united by partial sclerosis. The original bony tissue is 
relatively but little altered. 
(b) Scapula. The coracoid process is one-third united to the bone, but 
wants the epiphysis developed on it at about seventeen years of age. All 
the other epiphyses are absent. 
The bone is porous throughout, save at the centre of the infra-spinous 
fossa ; generally of the coarse variety, but very five in certain spots. The 
whole bone is somewhat thickened, as can be seen without any section, 
at its posterior border and on the spine. (Fig. 23.) The latter being to a 
great extent denuded of the outermost compact, yet porous layer of the 
new growth, shows the reticulated trabecule which supported it, and 
through their meshes the old external compact layer of the original bone 
now all worm eaten and very thin. his is especially well seen at the two 
extremities of the spine. The axillary border of the bone is three or four 
times as thick as is normal, has a few coarse osteophytes, and a very deep 
and wide groove for the dorsalis scapule artery. 
(c) Humerus. All the epiphyses are preserved except that of the in- 
ternal condyle. The trochlear surface projects only to a level with the 
radial. 
The whole shaft (Figs. 1 and 2) is involved in the disease, the least 
at the upper fourth, the other three-fourths being about alike. The 
porosity is almost wholly very fine or velvety. About two inches below 
the head, at the insertion of the Pect. maj., the anterior bicipital ridge is 
greatly thickened (especially on the right side). It is continuous with a 
very large elevated surface (2 1} in.) at the insertion of the deltoid. This 
is covered with a large mass of not very large porous osteophytes whose 
trend is generally upwards. One (r. side) or two (left) large flat imbricated 
osteophytes mark the posterior lip of the bicipital groove. At the musculo- 
spiral groove, which is well marked, the bone is finely porous, but presents 
no osteophytes. At the lower third, anteriorly, the bone presents numer- 
ous osteophytes, sometimes single, but generally in groups. They are 
sessile, porous, and in some cases imbricated ; their trend is generally 
downwards, except just above the epiphysis, where they are at right 
angles to the bone. The two condyloid ridges, especially the inner, are 
greatly diseased. The external ridge (especially on the right side) has 
several large porous sessile outgrowths with intervening grooves, the 
largest groove about corresponding in position to the anastomotica magna 
artery. The internal ridge up to the insertion of the coraco-brachialis is 
covered with large knobby and porous, imbricated osteophytes, continu- 
ous witha similar remarkable growth on the posterior surface of the bone, 
covering the origin of the internal head of the triceps, which extends to 
the musculo-spiral groove above, and fades into simple porosity exter- 
nally. Atthe origin of the external head of the triceps, there is also a 
