Contributions to practical surgery / by W.H. Van Buren.

  • Van Buren, W. H. (William Holme), 1819-1883.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical surgery / by W.H. Van Buren. 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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    patient of its aid, were in great part owing to the patient's familiarity with the influence of the opium, which, like the habitually excessive use of alcoholic stimulus, appears to interfere to some extent with its successful administration. As it was managed, how- ever, its ultimate effects could not have been happier in any respect. The question may be asked, as the tumor for which this second amputation was done was a reproduction of the original disease, on what ground was the diag- nosis founded that it was a simple exostosis, and not a malignant growth? I confess that the return of the disease was a suspicious circumstance, and also that the singular variety, as well as the comparative rarity of malignant tumors of bone, have united to render the question of their diagnosis not a little obscure. From the want of more certain knowledge with regard to their mode of development and histological peculiarities, it is sometimes impossible to arrive at a diagnosis as to their true nature, even under the microscope. In the present case, the nature of the disease was inferred from the uniform hardness of the tumor, its weight, and its striking and fanciful irregularities of outline; and it was confirmed by its slow growth, the absence until recently of pain, and its nature, the ab- sence of enlarged superficial veins, and also of the evidences of cachexia which generally accompanies malignant disease in its advanced stages. It will be observed that no one of the symptoms enumerated can be considered pathognomonic of benign, or of malignant disease—if we except perhaps the peculiar irregularity of outline—and to this symptom I would