Encysted osseous tumors, or a thin secreting membranous cyst : developed in cancellous structure of bone and surrounded by a thin bony wall / by Alden March.

  • March, Alden, 1795-1869.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: Encysted osseous tumors, or a thin secreting membranous cyst : developed in cancellous structure of bone and surrounded by a thin bony wall / by Alden March. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    Dupuytren says: To form a correct diagnosis of osseous cysts, requires much practice and experience. Prof. Syme says, cystic tumors of the jaw, grow in the sub- stance of the bone, and are generally, at some parts of their ex- tent, as hard and unyielding as bone, so that if the examination, be limited to those parts, the tumor will be supposed to be solid. I apprehend that the solidity and unyielding character, will be much more perceptible at a pretty early period of its growth, long before the compact walls become attenuated and reduced to a mere shell, by progressive absorption. We are told that distinguished surgeons have commenced an operation for the removal of what had been regarded a solid or osteoid tumor, when the knife happening to penetrate that portion of its outer wall, already reduced almost to a membrane, a copious flow of serous fluid revealed the nature of the swelling. This mistake may be avoided by making pressure with the fingers on all parts of the tumor; and if it is cystic, and in an advanced stage, we shall be pretty sure to detect its yielding and crackling character. Dupuytren says, Pressure with the finger on the thin shell of bone, will cause it to yield like a piece of very dry parchment, or a sheet of crumpled paper; this species of crepitation is a pathognomonic sign of great importance. But he further says, Should any doubt exist as to the real nature of the disease, the additional evidence obtained by punc- turing with an exploring needle, is sufficient to set the matter at rest. In the use of the grooved exploring needle, if the contents of the cyst be serum, or thin, and of a fluid character, it will be made manifest by the escape of a drop or two, either on the in- strument, or at the seat of the puncture, on its removal. Should the contents of the cyst be a soft solid, or encephaloid, the extremity of the needle penetrating the cavity of the cyst, may be made to oscillate or vibrate, something like the pendu- lum of a clock, by moving the portion of the instrument held with the fingers back and forth, or from side to side. On the other hand, if the interior of the tumor should be solid, and more or less firm, like a fibrous osteoid, or osteo-sarcomatous tumor,