The internal structure varies much in
appearance; generally it is brown and soft, in some places broken down
and mixed with a dark-coloured fluid, or with gelatiniform matter;
sometimes it is much more dense, and resembles cartilage; in others,
the cavity contains an ichorous fluid, mixed with small portions of
more solid matter; in the advanced stage of the disease, the contents
are often of the encephaloid nature, either in its homogeneous and
solid form, or softened, broken down, and mixed with blood, or with
a lard-like substance. Sometimes the cancelli of the bone are not
destroyed, but extended, forming numerous cavities of considerable
size, in which the morbid matter is deposited; in other instances,
there is no appearance of cancellated structure, and the diseased mass
contains rough osseous spicula, some detached, some loosely connected
with each other, and others projecting from the inner surface of the
bony parietes of the tumour. At the commencement of the disease, the
patient feels acute pain in the part, the constitution is disturbed;
afterwards, the pain becomes more dull, and there is a considerable
swelling externally, which feels hard, and slightly elastic; in the
advanced stage, the pain again becomes severe, and is of a lancinating
kind, and the system is much deranged, the tumour is softer, often
presents a sense of distinct fluctuation, and on being freely handled,
is found to crepitate, in consequence of the loose spicula of bone
rubbing upon each other. Ultimately, the integuments become tense,
livid, or dark-red, ulcerate, and allow a portion of the softened
tumour to protrude, in the form of a frightful fungus; there is profuse
discharge, thin, and sometimes bloody; there is much constitutional
irritation, and the patient is greatly exhausted. Not unfrequently,
during the progress of the disease, especially in the long bones,
fracture occurs at the diseased part, either from external injury, or
sudden muscular exertion. This occurred in the case from which the
specimen here delineated was obtained some months before the patient
submitted to amputation. The morbid structure had not broken through
its periosteal investment. The muscles and their interfilamentous
tissue were sound. The patient remained free from any return of the
local disease. Bones so affected, when broken, do not unite, the
movement of the loose and rough ends is a cause of much irritation:
inflammatory action is kindled in the morbid structure, suppuration
occurs, the integuments give way, and ulcerate to a greater or less
extent, and the advancement of the disease is thus much hastened. The
tumour may be safely pronounced malignant; it is true, that for some
time it shows no tendency to involve the adjoining soft parts, further
than by the effects of inflammation induced by its pressure; but then
it is limited by the external lamina of the bones, which confines
it to the tissue in which it originated; but after this barrier has
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