1881. 1 Observations concerning Transplantation of Bone. 235 



thirds of the graft remained in the tissues, apparently becoming in- 

 corporated with them and forming a firm hard layer. No opportunity 

 was afforded of demonstrating by an incision the exact condition of 

 the graft. Bearing in mind the repeated statement of Oilier, that 

 osseous grafts taken from one species and transplanted into another 

 species would not live, I am inclined to reserve expressing a positive 

 opinion on the success of the graft in this instance. 



Historical Resume. — The position of transplantation of bone is, 

 therefore, as follows : — In the lower animals Oilier has transplanted 

 periosteum and osseous tissue, and among many failures he succeeded 

 in one instance in forming an osseous ring from grafted periosteum, 

 and in another in transplanting a portion of bone from the one radius 

 to the other of the same animal. Wolf, of Berlin, repeated Ollier's 

 experiments, and stated that he never obtained an osseous growth 

 from any transplant. In man there have been several attempts to 

 transplant periosteum* and bone, which, with one exception, have 

 been attended with failure. The exception — the case mentioned of 

 grafting dog's bone into a human skull — has not been clearly 

 demonstrated. 



Points to be solved regarding Transplantation of Bone. 



It may be concluded, therefore, that the subject of transplantation 

 of bone and its subsequent growth have not yet been convincingly 

 proved, and that Ollier's experiments require further confirmation. 



The questions which are still at issue are — first, will bone grow after 

 transplantation ? Will it add any osseous increment to its bulk ? 



Second, are the facts derivable from animals applicable to man ? 



internal table of the skull protruded, which, when removed by the fingers, exposed the 

 pulsating brain destitute of its dura mater, but covered by the ordinary exuberant 

 granulations. A somewhat irregular aperture, an inch by half an inch, was left in 

 the osseous wall. In order to fill up this gap a dog six weeks old was taken, and a 

 portion of its parietal containing its ossifying centre was removed along with its 

 periosteum. It was shaped into the form of the gap, and inserted into the osseous 

 .aperture in the man's skull. A small hole was left for drainage from the interior of 

 the bone. Before transplanting, the skin which had been adhering to the edges of 

 the bone was elevated, and the bones were refreshed. After transplantation the 

 skin and tissues were drawn together over the graft, and united by sutures. Three 

 weeks after, about a third of the graft was found to have become necrosed, and 

 shortly after this part separated. The remaining two-thirds adhered firmly. Soon 

 after the removal of the necrosed part the wound completely closed. On pressing 

 the finger down on the skull, there seemed to be a little osseous elevation at the part 

 where the graft remained ; and as far as the finger could detect through the scalp, 

 the gap was filled by a hard resisting layer, apparently bone. 



* In a letter just received from Professor Oilier, he states that he has endeavoured 

 to transplant periosteum removed from the limbs of condemned criminals, placing 

 it in granulating wounds and ulcers. In one instance he found a hard part of 

 cartilaginous consistence, but the after result he was not able to follow. 



