given way, the tumour projects through the aperture, contaminating the
adjacent soft parts, imparting to them a morbid action, and extending
also in the cancellated tissue of the shaft of the bone. In some cases,
the integuments are tense and discoloured, with large vessels running
on their surface; the tumour feels soft and fluctuating, though the
skin may not ulcerate till long afterwards. Perhaps the most common
seat of this disease is the under-jaw, but it may occur in any of the
bones; when it has been of chronic duration, not one bone but several
are affected; and in one case which I saw, the disease commenced in the
under-jaw, which it deformed to a frightful degree; almost every bone
in the body was similarly, though less extensively diseased; this could
be readily observed during the life of the patient, and was confirmed
by dissection. From this, it appears, that the affection is not only
dependent on local causes, but connected with a morbid state of the
constitution, predisposing to it, and cooperating with its exciting
cause.
There are other tumours of bones in some degree resembling, which
do not strictly come under the term Osteosarcoma. Some are wholly
cartilaginous, the disease commencing in their centre, and involving
their entire substance, emitting a gelatinous fluid when cut, but
containing no cells; others are not uncommon, partly osseous, and
partly cartilaginous, containing cells filled with a glairy fluid;
others are composed of cartilage, intersected with dense fibrous
matter, in a greater or less proportion. In fact, the individual
tumours of bones vary as much from one another as those of the
softer tissues; scarcely two are alike in their progress, action,
or anatomical characters. Irregular spicula of bone are found in
many parts of their structure; in the same way that portions of bone
often exist in tumours having no connection with the bones; in many
places they are softened and broken down, the partitions between
the cells are destroyed, and these contain a pulpy mass of a dark
sanious appearance. On making a section, they are observed to be
continuous with the interior of the bone, which is converted into a
substance similar to themselves, or is of a more soft and medullary
character. The external surface becomes tuberculated, the integuments
are painful, and changed in appearance; they ulcerate, the tubercles
burst, the discharge is thin and bloody, the ulceration extends; not
unfrequently a fungus protrudes, and occasionally bleeds; this may
slough, the tumour becomes farther exposed, portions of it die, and
are discharged, unhealthy fungous granulations project from amongst
the cancelli of the tumour, and emit a sanious putrid discharge, often
bloody; severe constitutional irritation accompanies this state, the
patient becomes hectic, is much exhausted, and sinks, unless the morbid
parts be removed. There are also tumours of bones, composed partly of
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