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cartilaginous, encephaloid substance, softening towards the cir-cumference into a discoloured matter, bounded by a thin shellof bone, and having masses of fresh osseous deposit in its centre.The yellowish matter contrasts with the bluish appearance ofthe cartilage; a little fluid exudes from it, but it does not breakdown under the fingers. The osseous deposit is rather con-siderable, particularly where it is not so firm as in the centre.Exterior to the bone, posteriorly, are masses of fatty-lookingsubstance, they are firm, and appear like true encephaloid; infront are some osteoid portions, and nodules of bony matterencased in fibrous tissue. The joint is healthy, but the head ofthe fibula is a little injected. The disease extends down to themedullary canal, and between it and the marrow a gelatinoussubstance is observed, with mixed spiculæ of bone, this is also in-filtrated into the cancellous structure of the shaft. Under the

microscope, the firm substance shows characteristic cancer cells,with fatty degeneration. In the masses at the back of the jointthe cells are larger; and in the bony deposit they were fusiformand caudate.Here we have a bonâ fide cancerous growth, taking its de-

velopment in the head of the tibia, a portion of bone especiallyobnoxious to transformations of this kind. A feature worthyof note, is the absence of pain in the four years during whichthe disease invaded the process which it eventually destroyed;and we may also mention the immunity enjoyed by the cavityof the articulation while these serious changes were going on.This tumour must be placed amongst the variety called firm

medullary cancer, and belongs to those which form distinctmasses in the articular ends of bone, round which the wallsare expanded into a shell. The patient is doing well, and islikely to recover from the effects of the operation; but as torecurrence, it is but too probable that it will take place, theaverage life after removal of limbs affected with medullarycancer being, according to Mr. Paget, about thirty months.This author says :-" If the operation be recovered from, theregular course of events brings about the renewal of cancerousgrowth, either near the seat of the former growth, or in thelymphatics connected therewith, or, more rarely, in somedistant part ...... Recurrence and death occur, on the whole,more tardily after amputations for medullary cancers of thebones and soft parts of the limbs than after extirpation of theeye or testicle......Now, respecting the propriety of removinga medullary cancer in any single case, it may be said that thehope of finally curing the disease should not be entertained.Such an event may happen, but the chance of it is not greaterthan that of the disease being spontaneously cured or arrested;and the chance of any of these things is too slight to be weighedin the decision of any single case. The question in each caseis, whether life may be so prolonged, or its sufferings so

diminished, as to justify the risk of the operation. In general,I think, the answer must be affirmative wherever the diseasecan be wholly removed, and the cachexia is not so manifest asto make it probable that the operation will of itself provefatal. "

We now would for a few moments direct the attention ofour readers to a case of medullary cancer of bone, the situationof which precluded any surgical interference; we shall thus beenabled to study the rise, progress, and issue of the diseasewhen art is powerless in arresting its fatal tendencies.

KING’S COLLEGE HOSPITAL.MEDULLARY CANCER OF THE ILIUM, PRESENTING VERY STRONG

PULSATIONS.

(Under the care of Mr. FERGUSSON.)JAMES B-, aged fifty-six years, was admitted May 4th,

1854, with a pulsating tumour, situated on the posterior partof the left ischium.The patient states, that about four months before admission

he begun to feel some pain in the above-named region, whichwas at first trifling, but increased on the slightest exertion, andwas always relieved by rest. This pain became gradually moresevere until six weeks before his application here, when itcame on rather more abruptly than usual, and it was then thathe first perceived a swelling at the spot where the pain wasexperienced. The tumour was then about the size of the lastphalanx of an adult thumb, there being distinct pulsations in it.

(To be continued.)

EPIDEMIOLOGICAL SOCIETY.-The first meeting of thepresent session of this Society will be held on Monday, the6th of November, at half-past eight P.M., at 37, Soho-square.An introductory address will be delivered by the president,Dr. Babington. Afterwards a discussion will take place rela-tive to the late visitation of cholera.

Reviews and Notices of Books.

Transactions of the Pathological Society of London. Vol. V.Including the Report of the Proceedings for the Session1853-54. pp. 371.

IN calling the attention of the profession to this interestingvolume, we would preface our observations by expressing thehigh sense which we entertain of the respectability and utilityof the Society from which it has emanated. The Society is, inour judgment, second to none in practical value and in theactive support which it receives from the most distinguishedmembers of our profession. It is also a pattern to othersimilar institutions in the economy with which its generalaffairs are managed, as evinced by the publication of so hand-some a volume out of the yearly subscription of one guineapaid by its members.

The " getting up" of this work is highly creditable to thehon. secretaries, and the literary character of the articles doeshonour to the contributors; whilst no fewer than seventeen largeplates, containing a multitude of drawings, and several wood-cuts, illustrate and decorate its pages. There is also a goodgeneral index of the contents, but we think the work lackingin a separate catalogue of the subjects of the illustrations. Thereis also an indefiniteness about the expression, " List of Speci-mens exhibited at the Meetings of the Society during the Session1853-54;" for since that list is, in fact, a catalogue of thecontents of the volume, it would appear that all communicationsmade to the Society were admitted into the " Transactions"-a statement which cannot be correct.We must also offer our approval of the microscopic character

with which the plates have been invested, and of the artisticand faithful mode, as we believe, in which they have beenexecuted. Such drawings are peculiarly fitted for the " Trans-actions" of our learned societies, since matters of great interestand novelty may thus be rapidly and simultaneously broughtunder notice in a department which has been, and still pro.mises to be, the most fruitful in results.The contents of the volume consist of 135 communications,

and are arranged under nine heads - viz., Diseases of theNervous System, Organs of Respiration, Hsart, Organs of

Digestion, Urinary and Generative Organs, Osseous System,and Ear; with papers on various miscellaneous subjects, and,on Diseases of the Lower Animals. Our space will not permitus to notice every article, but we shall give an analysis of themost interesting cases’.

Diseases of the Nervous System are illustrated by twelve communications. Thus, Dr. Ogleexhibited a cyst from the meshes of the pia mater of the brain,which produced absorption of the convolutions of the surface;also a cyst at the base of the brain, formed by the softening ofscrofulous deposit, and clearly indicated during life as to itsposition by certain well-marked symptoms; and a specimen,showing extensive softening of the entire spinal cord, with-out discoloration thereof. Dr. Bristowe exhibited a tumour,probably epithelial cancer of the dura mater. Mr. JohnWood exhibited a brain and dura mater taken from a manafter a blow on the head. Mr. Toynbee exhibited a diseasedbrain arising from caries of the temporal bone after scarletfever. Dr. Septimus Gibbon exhibited the left middle cerebralartery, plugged with a fibrinous clot, the result of phlebitis.Dr. Markham showed a cancerous tumour in the posterior lobeof the right hemisphere of the brain. Dr. Hall related a caseof chronic abscess of the brain, giving rise to symptoms re-sembling chorea. Mr. Shaw exhibited a fibrous tumour on theleft ventricle of the brain; and a bony deposit in the arachnoidmembraneoftherighthemisphere. Dr.PeacockandDr. Thuniampresented a cholestea-tomatous tumour of the brain; and Dr.Sankey described a mode of taking the specific gravity ofhealthy and diseased brain. Of these, Dr. Bristowe’s and Dr.Peacock’s tumours are illustrated by twelve figures.