A system of surgery : theoretical and practical . ossify in the strict sense ofthe term; but they undergo, when very old, a process of calcareous degeneration,which, added to their general increase in size, produces ulceration of the skin overthem; and so a condition is brought about not unlike that of a mass of enormouschalkstones exposed. More rarely the tumours spring from the surface of the bones.^ ^ Ueber den feinern Ban und die Formen der hrankhaften Geschwiihte. Berlin, 1838,tab. iv. fig. 1. - Path. Soc. Trans, vol. ix. p. 382. Tlie specimen is in the Museum of St. Georo-esHospital. * W
A system of surgery : theoretical and practical . ossify in the strict sense ofthe term; but they undergo, when very old, a process of calcareous degeneration,which, added to their general increase in size, produces ulceration of the skin overthem; and so a condition is brought about not unlike that of a mass of enormouschalkstones exposed. More rarely the tumours spring from the surface of the bones.^ ^ Ueber den feinern Ban und die Formen der hrankhaften Geschwiihte. Berlin, 1838,tab. iv. fig. 1. - Path. Soc. Trans, vol. ix. p. 382. Tlie specimen is in the Museum of St. Georo-esHospital. * With regard to the ordinary seat of cartilaginous tumours of bone, Dr. Pirrie makes thefollowing observations, which I believe to be generally true : * I have now seen in my ownexperience nine specimens of cartilaginous tumours near the ends of long bones, and they haveall been situated between the walls of the bone and the periosteum, and in no instanceextended to the cartilage of incrustation at the end of the bone. I have met with fifteen V 324 DISEASES OF THE BONES. Circumscribed and solitary enchondromata usually grow from the surface of abone, and most of tliem show a strong tendency to ossify, the process commencinggenerally at the base. Hence the surgical considerations applicable to them areidentical with those which apply to exostosis. When a circumscribed enchondromagrows in the interior of a bone, as in fig. 60, it can be readily enucleated, andwhen a small cartilaginous tumour springs (as it often does) from the end of thelast phalanx, usually of the great toe, its removal is very easy, and is always, as faras I have seen, permanently successful. Diagnosis.—The diagnosis of innocent tumours from each other is uncertain andobscure in all parts of the body, and perhaps more so when they are connected withthe bones, on account of the generally deep position of the latter. If, however, atumour presenting the general characters of innocency can be clearly made out
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