1881.] Observations concerning Transplantation of Bone. 245 



acted as a stimulus to it ? In answer, it must be borne in mind, that 

 had periosteum existed, between the condyles and the upper part of 

 the humerus, it had ample opportunity of revealing itself by osseous 

 growth, during the fifteen months which elapsed between the removal 

 of the dead bone and the transplantation of the new. Again, in 

 opening up the sulcus between the muscles for the reception of the 

 transplants, neither periosteum nor any vestige of like fibrous mem- 

 brane was seen ; so much so, that it was only by recognising the 

 relative positions which the muscles ought to occupy toward the 

 humerus, that a guide to the correct position of the transplants was 

 found. Further, the growth of bone in the arm was at first only 

 commensurate with the transplants. There was no indication of 

 osseous growth in the vicinity of the transplant which might have 

 arisen from the "supposed stimulated periosteum." Finally, the 

 solid humerus still retains the irregularities of shape which the trans- 

 plants were permitted to assume in the tissues. So that there is not 

 an iota of fact to support the supposition that the new bone grew from 

 old periosteum. 



Transplants not being Absorbed. 



Secondly, it is stated that though transplanted bone may be 

 retained in the tissues, yet it may be simply encapsuled and be under- 

 going slow absorption. If absorption were taking place the changes 

 so brought about ought to be apparent by this time. The first graft 

 was made one year and five months ago, the last nine months since 

 (this is written on 12th April, 1881), and the bone formed after the 

 healing of the wound made for the reception of the graft has not only 

 maintained its original dimensions but has grown. This sufficiently 

 sets at rest the question of absorption of the transplanted bone. 



The way being thus clear, the conclusions drawn from the data 

 supplied by these experiments may be considered. To commence 

 with the questions in the order in which they are placed at the 

 beginning of this paper. What evidence do these experiments afford 

 as to the growth of transplanted bone ? 



Proofs of Growth of Transplants. 



When from six human lower limbs six wedges of bone (along with 

 their periosteum and marrow) are removed, divided into small pieces, 

 placed in the arm of a boy, in an intermuscular space freshly opened 

 by the scalpel for their reception ; and when it is seen that, with the 

 exception of a few fragments of bone which were shed, the whole of 

 the grafted portions united one to another and to the ends of the 

 original bone ; making in all four and a-half inches of osseous 

 transplant, whereby a united humerus has been formed, which he 

 moves and uses as the other arm ; it may be concluded that the trans- 



