246 Observations concerning Transplantation of Bone. [May 19, 



planted bones have lived and grown. Before these transplanted por- 

 tions of bone conld have united together, there must have been a 

 proliferation of the bone-forming elements contained in the grafts. 

 That the development of fresh bone originated in the transplants is 

 typically illustrated, where the second transplant nnited to the first by 

 one end, while its other extremity was free in the tissues ; so that it 

 did not come into contact with the original bone at any part. Yet 

 this transplant consolidated just as well as the first or second trans- 

 plant did. As further illustrations of the vitality of the transplants 

 and the growth of new bone from them, there is, firstly, the evidence 

 derivable from the callus thrown out between the second and third 

 transplants, after their extremities were refreshed, the same phe- 

 nomena being observed here as in an ordinary case of ununited 

 fracture. Secondly, the bones became sensibly thicker at the point 

 where they were drilled for the reception of the pegs. All these are 

 evidences of actual growth of bone from the transplants. 



Vascularity of Transplants. 



When the extremities of the second and third transplants were 

 refreshed, the appearance of both bones was that of living osseous 

 tissue ; surrounded by a thin fibrous vascular membrane closely 

 adherent to the bone, and which bled when it was scraped up, 

 much in the same way as periosteum would under similar circum- 

 stances. This membrane did not resemble the thick semi-vascular 

 capsule which is found surrounding dead tissue in process of being 

 absorbed. 



These facts being derived from the interhuman transplantation are, 

 as they stand, a sufficient answer to the second question ; while the 

 utility of the arm after restoration of two-thirds of the humeral shaft 

 establishes the practical results of the operation. 



The method of division of the bone into small pieces prior to trans- 

 plantation, and the a priori reasons for doing so, have been borne 

 out by the success which has attended the practical performance of 

 the operations. 



Conclusion. 



From the foregoing the following may be formulated : — 



1. Transplanted bone is capable of living and growing. 



2. Interhuman transplants of bone live and grow. 



3. Interhuman osseous transplants are capable of being put to 

 practical uses beneficial to mankind. 



4. The whole of the osseous elements ought to be included in the 

 transplants. 



5. The most successful mode of transplanting bone is to divide it 



