84 THOMPSON YATES LABORATORIES REPORT 
there was no transformation of bone into a lower type of connective tissue, such as has been 
observed in undoubted cases of osteomalacia, and there was an entire absence of osteoclasts. Dry 
preparations of these bones likewise showed a normal structure. On the other hand, in the rib, 
the delicate bony shell, which was cut in transverse section, appeared to have undergone 
retrograde changes ; the normal lacunar and canals were feebly represented, and where present 
were irregular in shape and distribution. On the inner surface they seemed to have entirely 
disappeared, and that part of the bone liad a fibrous and at the same time dotted structure 
strongly suggestive of a reversion to a fibrous connective tissue. Indeed, the recognition of the 
tissue as bone would not have been easy had the facts of the case not been already known 
(PI. XIII, Fig. 5). 
Owing to the thinness of the bony shell it was impossible to prepare a dry transverse 
section of the rib so as to compare the inner and outer parts. A dry tangential section showed a 
perfectly normal arrangement of lacunae and canaliculi (PL XIII, Fig. 6). 
Kidneys. — The microscopic appearance was practically that met with In the milder forms 
of chronic interstitial nephritis ; the connective tissues showed at places proliferation, and the 
cells of the tubules were found to be in a granular degenerated state, and occasionally lying free 
in the lumen. 
Sunt7nary of the morbid anatomy. — As far as the limited examination which was permitted 
enabled us to ascertain, the characteristic lesions were confined to the bones of the trunk, but it 
is possible that the cranial bones were affected in a similar way. These lesions consisted in a 
disappearance of the osseous tissue, beginning centrally, and the growth in its place of a soft 
vascular mass of undifferentiated round cells. The remaining osseous tissue of the rib appears to 
have undergone retrograde changes, but that of the other bones shows normal characteristics, 
from which we infer that the primary lesion was the invasion by the cellular growth. There 
is no evidence to suggest the existence at any time of primary disease of the kidneys, the changes 
found in these organs being such as can be accounted for by the irritation arising from the 
passage through them of the abnormal material which they excreted for many months. 
It is obvious that the histological characters of the growth in the interior of the bones 
merely show that it consists of embryonic cells which have undergone little or no differentiation, 
and are separated by a very small amount of intercellular substance. It might, therefore, 
be regarded, anatomically, either as a round-celled sarcoma, a lymphoma, or a granuloma. 
Clinically, its progressive development and fatal issue seem to entitle it to rank with the malignant 
neoplasms ; but it differs from them in remaining strictly limited to one kind of structure and 
not spreading, either to contiguous parts or to distant organs. The cellular mass has originated 
apparently in the cancellous tissue or marrow spaces of the ribs, sternum, and vertebrae, and by 
its proliferation has caused absorption of tiie earthy salts and the proper tissue of the bone. 
When we come to consider the patliological relationship of this condition we find that, 
apart from rickets, which only affects the growing bone, cases of extreme flexibility and brittleness 
of bone fall into two great divisions. On the one hand, we have those in which the essential 
pathological change is a simple absorption of the earthy salts — the Halisteresis Ossium of some 
