OSTEO-SAliCOMATOUS TUMOUR, 
557 
was firmly held by an assistant,. I made an incision through the 
skin, round the tumour, at nine centimetres from its base. I then 
made two other incisions, one in the direction of the larger, and 
the other of the smaller diameter of the tumour, and reaching from 
the circular incision to the base of the tumour. I next dissected 
down these four divisions of skin, comprised in these crucial inci- 
sions, to the base of the tumour. I then dissected them off a little 
farther, in order that I might examine the construction of the base. 
I found that it was of an osseous character. 1 began to use my saw 
along the base of the tumour at the superior part of the forehead, 
and penetrated to about the depth of nine centimetres into its sub- 
stance : I then stopped, when I perceived that the saw met only with 
some fleshy substance, and I attacked the portion of it on the nasal 
bones. An assistant, by means of strong hooks applied to the part 
that was cut through, drew the tumour forcibly forward towards the 
nasal bones, and I amputated the rest of the tumour with a bis- 
toury. I met with considerable resistance on the lateral and supe- 
rior parts of the tumour, towards the mesian line, and central point 
of its base. I avoided the resisting portions, which consisted of 
bony matter belonging to the large superior maxillary bones, and 
to the points of the two nasal bones. The bistoury separated the 
soft parts from these bones, and the tumour was soon entirely 
removed. The two superior maxillary bones formed on each side, 
at their nasal border, a symmetrical projection, evidently occasioned, 
at first, by their deviation outwards, and afterwards by some rough 
and irregular exostoses, which were developed in two longitudinal 
lines upon their borders. I presently removed these by the assist- 
ance of a mallet and sharp chisel. Their tissue was very com- 
pact. There remained nothing more, then, but the projection of 
the median line, and this was surmounted by a roughened crest, 
which had penetrated into the soft part of the tumour to the depth 
of three centimetres. This appertained to the prolonged portion of 
the superior nasal bones, and was formed of a spongy tissue, dif- 
ficult, nevertheless, to cut through with the bistoury. The whole 
of this portion of the nasal bones had the same texture. In endea- 
vouring to cut down and to equalize these surfaces, so that the head 
might resume its pristine form, a portion of the nasal septum, to 
nearly the extent of six centimetres, was loosened. I immediately 
r moved the detached part. 
In the region where the superior nasal bones had been separated 
by the presence of the tumour, the upper portion of them had 
acquired considerable development. There was a chasm between 
them ; and the tumour had, as it were, made an irruption into the 
nasal fossae, and some of the bony growths had slightly compressed 
VOL. XII. 4 D 
