. The principles of surgery . ce, of a simple kind, there is medul-lary deposit; commencing usually at a cen-tral part. The osseous skeleton for a timeremains; but sooner or later it disappears,and its place is occupied by a soft brain-likemass. The exterior osseous shell, in likemanner, is involved and changed ; ulcerationfollows; the medullary substance, then ex-posed and unconfined, quickly establishesthe condition of fungus ; and an untowardprogress is made, similar to what has beenalready described in the soft tissues (p. 320).More frequently, the tumour is from the firs
. The principles of surgery . ce, of a simple kind, there is medul-lary deposit; commencing usually at a cen-tral part. The osseous skeleton for a timeremains; but sooner or later it disappears,and its place is occupied by a soft brain-likemass. The exterior osseous shell, in likemanner, is involved and changed ; ulcerationfollows; the medullary substance, then ex-posed and unconfined, quickly establishesthe condition of fungus ; and an untowardprogress is made, similar to what has beenalready described in the soft tissues (p. 320).More frequently, the tumour is from the first; making no change,except from the occult to the open state,and perhaps to assume the condition offungus hematodes ; rapid, painful, involvingall textures, pushing none aside, and attended by a most marked andwasting cachexy. Sometimes the brain-like mass originates in thesoft textures exterior to bone, and involves the latter in some cases, portions of fat have been found coexistent withthe medullary Fig. 150. Section of Osteocephaloma affecting the lower part of the femur; a verycommon site. The whole bone at that part is converted into a pulpy brain-like mass. DIAGNOSIS OF TUMOURS OF BONE. 457 Fig. 161. When the tumour forms in the shaft of a long bone, fracture is stillmore likely to occur than in osteosarcoma ; greatly aggravating theuntoward progress of the disease. Treatment is by early and thorough removal. Amputation of thelimb is usually preferable to extirpation of thepart ; and it is a safe general rule, that,when practicable, the bone in which thetumour has been produced should not be sawnthrough at any part, but disarticulated. Ifan opportunity for early interference be notafforded, the knife should be withheld, andpalliatives alone employed. Diagnosis.—Practically, it is of the utmostimportance, that we should be able to distin-guish between osteosarcoma and osteocepha-loma. Each is of not unfrequent occurrence ;and each requires disti
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