88 
THOMPSON YATES LABORATORIES REPORT 
under the care of Professor Senator, and died in October, 1897.* She suffered from severe 
pains in the chest and back, and paralysis of one of the hypoglossal nerves. No deformities appear 
to have been noticed, and the diagnosis was nephritis with albumosuria. The post-mortem 
showed the presence of a new formation in several of the ribs proceeding from the medulla and 
regarded as a myelogenous round- celled sarcoma. The kidneys were amyloid. 
A case reported by Noel Paton and Byrom Bramwell was, at one time, believed by 
Professor Huppert to belong to this class. In the former paper the author (Dr. Bradshaw) 
expressed doubts as to the correctness of this view, and quite recently Professor Huppert has 
abandoned it.t 
In all these cases the condition of the bones was either altogether overlooked during life, or 
was considered to be osteomalacia. In KIthne's the absence of an autopsy leaves us in some doubt 
as to the actual condition of the bones, but it was probably the same as in the others. 
It thus appears that our case is the first published case of albumosuria in which the diagnosis 
of multiple bone tumour was made during life ; and further, that it is the first case in which the 
diagnosis made during life has been confirmed by the post-mortem examination. 
Quite recently one of us (T, R. B.) has been informed by Dr. Reginald H. FiTZ, of 
Boston, of another case not yet published, in which the diagnosis was made during life and 
confirmed by the autopsy. A brief reference to this case will be found in a paper read before the 
Association of American Physicians last May.J 
The records of the six cases we have given in detail show a general resemblance in their 
morbid anatomy, and this resemblance is shared by the case we have described ourselves. The 
appearances are by no means identical, and we find in the records of cases where no albumosuria 
was observed descriptions of microscopical appearances indistinguishable from those described in 
the records of the cases we have quoted.^ This is, perhaps, to be expected, since round-celled 
formations may undergo various degrees of evolution, as we observe taking place in various kinds 
of sarcoma. It seems to us that the mere microscopical characters of the growths do not by 
themselves form any sound basis of classification ; but we maintain that, in spite of their observed 
differences in structure, the occurrence of albumosuria entitles these cases to be placed in a category 
by themselves. 
That a morbid process taking place in a region remote from the kidneys should be associated 
with the presence in the urine, for a long period, of large quantities of a substance which it does not 
contain in any other circumstances, is a rare event in pathology. The presence, however, in such 
a condition, of a substance not only foreign to normal urine, but unknown to the pathological 
chemist in any other connection, is probably without a parallel. The most obvious analogy, 
though it is only a remote one, is the occurrence of sugar in the urine in association with disease 
of the pancreas ; but, in that case, we have only to deal with a familiar chemical substance which is 
* Rosin. ' Ueber einen eigenartigen Eiweiss-K'urper im Harne, &c. Berliner klin. Woch.,' 1897, No. 48. 
t Huppert. 'Ueber den Nbel-Paton's chen Eiweiss-Korper. Centralb. f. (1. med. Wissensch.,' 1898, No. 28. 
J R. H. Fitz. 'The significance of Albumosuria in Medical Practice, &c. Amer. Journ. of the Med. Sciences,' July, 
1 898, p. 30. 
§ F. Parkes Weber. ' General Lyniphadenomatosis of Bones, &c. Journ. of Path. an<l Bact.,' January, 1898. 
