ay 
30 [Dee. 
Pepper. ] 
to view the original but altered bone. Posteriorly the osteophyte growth 
extends from half an inch below the lesser trochanter to within 2} inches 
of the end of the shaft, and the same sheath-like appearance is very no- 
ticeable at its two extremities. Where not covered with osteophytes, the 
shaft is very finely porous and thickened. All the central two-thirds of the 
shaft is one vast mass of large, irregular, porous osteophytes. Their di- 
rection is not constant, but is in general downwards, and their shapes are 
very varied. The massextends for about eight inches, along what was the 
tolerably sharp linea aspera, but is now about } in. wide and about ¢ inch 
thick. The posterior inter-trochanteric line and great trochanter are not 
affected, except a slight porosity in the former. The lesser trochanter is 
wanting, but for } in. around it there is no disease beyond some porosity 
save one squamous osteophyte on the right side. 
On section (Fig. 5) in the axis of the head and great trochanter the out- 
line of the old bone is not to be made out save internally, and then only 
imperfectly. The old and new growths are almost everywhere indistin- 
guishably welded together. The lamine of the new growth, too, are 
welded together save at a very few points. The old compact wall is still 
solid, but it looks granular and does not present the ivory-like solidity of 
normal compact tissue. The medullary canal is somewhat enlarged at 
the expense of its walls. At the lower extremity the trabeculw of the can- 
cellated substance are normal, but in the head and neck the arches for 
mechanical support are much less distinctly marked than is usual. 
(c) Patella. The right patella is missing. The anterior surface of the 
left shows a few osteophytes trending downwards. 
(d) Tibia. Both the upper epiphyses are preserved. The whole bone 
is greatly diseased and thickened to about twice its usual diameter. The 
tubercle is slightly thickened and presents a ragged edge above for 
articulation with the epiphyses, but the greater part of the tubercle being 
developed from the epiphyses the disease is not very marked. The crest 
is rounded in its whole length and porous. The internal sub-cutaneous 
surface presents marked syelling and porosity. There is but little oste- 
ophyte growth, and it is generally in the laminz except at the sartorius 
insertion, where it is more developed. A number of deep grooves exist, 
generally longitudinal in their direction and most marked at the upper 
third. The posterior and external surfaces are covered with a warty 
growth of porous osteophytes which attain their greatest development 
at the interosseous border and especially at the oblique line. The gen- 
eral trend of all this growth is downwards. Grooves for the vessels are 
frequent and tolerably deep. : 
On section (antero-posterior) the outline of the old bone is distinct at 
the extremities, but in the central two-thirds it is barely visible in front 
and wholly lost behind, the sclerosis at this part having welded together 
all the lamine of the new growth and the original bone. Even at the ex- 
tremities the new lamine are not very marked. The rarefaction of the 
original compact substance is of course therefore not marked. The me- 
dullary canal if at all altered is narrowed by the encroaching sclerosis. 
