662 MORBID ANATOMY.
and from this process forward to the larynx. It was knobbed, and mostly hard, but some parts were soft and fluctuating. Skin tense but unbroken. Larynx pushed to one side, but moved independently of the mass.
On the 21st the entire tumor was removed ; and, though the mucous membrane of the mouth was pushed before it, and the pharynx and oesophagus were to a large extent in close contact with it, no opening was made into these cav- ities. There was much venous hemorrhage, and conse- quent depression ; but no lai'ge vessel was cut. The ramus of the lower jaw was bent inward by the growth of the mass, and it was necessary to divide it at the angle. It was also necessary, for the command of the tongue, to use the forceps and a double ligature.
On examination of the tumor, Dr. B. found it sufficiently hard and smooth, as if invested by a fibrous capsule ; with very marked lobes and fissures, and in the deepest of which had lain the ramus of the jaw. On section, it appeared to be a well-marked specimen of the mixed cartilaginous tu- mor of Paget ; surface flat, with small, honeycomb cham- bers, and anfractuous and discolored cavities, traversed by bands, and filled with bloody serum. Portions of the mass were dense, opaque, white, and finely mixed with a bluish, enchondromatous tissue. Other portions were more uni- formly cream-colored, and softer, without the enchondrorna. The enchondromatous portions showed unequivocal carti- lage cavities, somewhat imperfect in their structure, and marked with tough and branching fibre. The cream- colored tissue was more distinctly cellular and granular. The cells were extremely irregular ; mostly caudate and fusiform, or with processes ; but they showed none of the rounded cells of some cancerous growths, to which last the tumor bore no resemblance.
In regard to the nature of the tumor, Dr. B. thought that until the last few years it might have been regarded as benign ; but that its late rapid growth would suggest the idea of its return.
On the 13th of Feb. the wound was healing fast, and the man left the hospital ; the hearing in his right ear, which had been lost for many years, having been restored.
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