1881.] Observations concerning Transplantation of Bone. 241 



boy's arm. They were kept under the spray from the time they were 

 removed from the tibieo until they were covered by the soft parts of 

 the arm and its antiseptic dressing. The time occupied in removing 

 the wedges, cutting them into fragments, and placing them in the 

 living tissues of the arm, was about two to three minutes. A drain of 

 horsehair was inserted, and the wound was carefully stitched and 

 dressed. 



The wound healed without pus production. The patient's tempera- 

 ture remained normal throughout. 



A month after the operation the arm was looked at for the third 

 time, when the transplant felt firm and united. 



Result of the first Transplant. — Two months after, it was thoroughly 

 examined, when a portion of the bone, 1 inch in length and, as far as 

 could be measured, nearly three-quarters of an inch in thickness, was 

 found firmly attached to the upper fragment of the shaft. In running 

 the finger from the head of the bone towards the graft, the latter could 

 be distinguished by its greater breadth. At this time, instead of the 

 former sharp spike, the upper fragment ended in an obtuse terminal. 



Placing the arm by the side, the measurement from the tip of the 

 acromion process to the extremity of the bone was now 2£ inches. 

 That was a distinct gain of 1 inch in length. The arm was shown in 

 this condition to the Glasgow Pathological Society. 



Second Transplant. — On February 1st, 1880, the upper fragment was* 

 laid bare, the extremity of the first graft was exposed, and found to be 

 covered by a fibrous vascular membrane, which had to be elevated in 

 the same way as periosteum. ■ Under this there was distinct cal- 

 careous tissue, which had all the appearance of living bone. A 

 sulcus was made between the muscles for the reception of fresh grafts r 

 which were obtained from a patient five years of age, affected with 

 anterior tibial curves. The wedges were divided into larger pieces 

 than the first graft. 



Some of these measured half an inch by a quarter of an inch, but the 

 majority were about one-eighth of an inch by one-sixteenth. 



The child kept well up to the third week, when the temperature 

 suddenly rose, and on examination some pus was found on the dress- 

 ing, and one of the larger pieces of bone was discovered on the surface 

 of the wound. Afterwards several portions of bone were shed. The 

 portions were mostly the larger pieces of the graft. The smaller 

 fragments remained. Thus about one-third of the second graft came 

 away. The portions of bone which were shed were eroded, small 

 hollows being formed on their surface, filled with granulation tissue. 

 After these parts were removed, there was a distinct firm mass of bone 

 left. 



Result of the second Transplant. — On April 20th (about two and a half 

 months after the second graft) the measurement from the tip of the 



