We therefore do not offer a very positive or de cided opinion on this subject.
But that the bones in the vicinity of can cerous disease often suffer from a malignant and incurable species of caries, quite distinct and separate from that absorption which might be the result of pressure, and that this caries illustrates Mr. Hunter's position of the exist ence of a cancerous disposition in parts ap parently sound, which will afterwards become developed even though the cancer is removed by operation, admits, we think, of most irre fragable proof. Several years since, we re moved a very large cancerous ulceration in volving most of the under lip, the angle of the mouth, and part of the upper lip also. The diseased parts were most unsparingly taken away, and a minute and careful examination could not detect the smallest hardness in any part of the extensive resultincr wound. Never theless, in less than a year a(terwards a tumour appeared at tbe angle of tbe jaw, with a hard and unyielding band striking from it deeply into the neck. The tumour increased and pressed deeply : an operation was altogether out of the question, and the man died of open cancerous ulceration. On dissection the bone was found to be deeply and extensively eaten away by caries : its entire structure was pre ternaturally softened, and on attempting to dry it, as an anatomical preparation, its earthy material crumbled away and was altogether lost. At this moment Nve have another case, affording a similar example of cancer attacking the lower jaw after being apparently removed from the lip. The bone is swollen, hard, nodulated, and extremely painful ; but not withstanding the urgent entreaties of the poor man, no operation can be performed, and he too will die of open cancer. But the point is too well understood by operating surgeons to require further elucidation. Every one must have met with cases of extirpation of the breast where the ribs had been found softened and diseased, although little indication might have previously existed of such an unfortunate complication.
13ut with reference to fungus hmmatodes the question is by no means so easily settled. In very many cases of extirpation of the eye in consequence of this disease, the bones of the orbit, even at a very early period, have been found softened, altered, and spoiled, new and more irritable growths have sprung from their substance, and the affection has re-appeared in a worse, because a more incurable form. Operations about the upper jaw have too fre quently proved failures from a similar cause. Again, although the immediate points of re ference have escaped our recollection, we have read of cases of fungus hwinotodes, the very first and earliest symptom of which was a fracture of the bone or bones of the member in which the disease afterwards was extensively developed. In our own note-book are two such cases. One, a poor boy admitted into the Meath Hospital in the year 1820, with the most frightful enlargement of the thigh per haps ever witnessed, the circumference of the limb being much larger than that of the body of an ordinary man. He attributed the dis ease to the almost spontaneous breaking of the thigh-bone whilst he was riding on an ass. The tumour never ulcerated, but as an ope ration, even at the hip-joint, was decided on in consultation to be practicable, he left the hospital, went to the country, and was lost sight of. A case nearly similar occurred shortly afterwards in the shoulder of a young woman, the first symptom of which seemed to have been a fracture of the humerus. Both these cases were at the time regarded as spe cimens of fungus hmmatodes, and as they were not examined, the question must still remain undetermined ; but from what we have since observed, we should be disposed to think they were osteo-sarcoma. It is, perhaps, right to state that many surgeons of high attainments and great experience do not separate these diseases in their own minds, and still reoard the affection of the bone, which we wouldien title osteo-sarcoma, as a species of fungus h matodes.