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metastases among fifty-seven primary renal carcino- mas has the result : 3.6 per cent. Bone metastases in other organs are rare ; only isolated cases are found in the literature. Throat. Oster, 1880, observed a metastasis in the humerus after esophageal carcinoma. Fitting reported a case where cancroid of the proventil mdi ulna led to a long search for the primary proventil nebulizer site, which was at last found in the larynx on the plica epiglottica sinis- tra. A multiple carcinosis in the left humerus, fe- Sanie as plate i, taken thirteen weeks later, June 23, 1914. mur. and in the vertebrae, after primary pulmonary cancer, is described by Deuchler. Erbsloh report's multiple bone metastases after primary carcinoma of the bihary ducts. Bladder. Geissler has reported a case of primary bladder carcinoma. This was discovered only two months after extirpation of a large scapular tumor, when proventil hfa inhaler the patient came in with a hematuria. F"uzi- nami reports the very rare case of metastasis in left femur with spontaneous fracture following primary cancer of the rectum which remained latent. We conclude from the foregoing that of primary carcinomas, thyroid cancer ranks first in relation to bone metastases : then follows mammary carcinoma, proventil albuterol and on a par with it is prostatic carcinoma. Then come uterine cancer and ])robably renal cancer. Hassner then discusses the pathology and histologi- cal study from von ventolin proventil Recklinghausen's point of view, whom he quotes extensively. coupon for proventil Bretschneifler (6) states that in proventil inhalers the cases report- ed by von Recklinghausen, Sasse, Braun. Bam- berger and Paltauf. Sidney M. Cone, and Erbsloh all showed a great similarity as regards the struc- ture of the primary lesions and the regular dissem- 1 154 MATTHEWS: CARCINOMA OF BONE. [New York Medical Journal. inated distribution of the bone metastases. Why the prostatic and also the mammary cancers tend in their skeletal metastases to new formation of proventil 90 mcg bone tissue, while in other carcinomas, for example, the thyroid, almost never osteoplasty is observed, is still unexplained. Also, why is it that especially prostatic car- cinomas, also mammary and thyroid cancers, affect the bone marrow by preference, while in other pri- mary carcinomas this preference for the bony apparatus is not observed? proventil hfa coupon Neuser supports the theory that in the prostate, breast, and thyroid, we see the links of a system which are in close relation- ship with the blood. This relationship is manifested by increased bone marrow elements in the blood preparation. Bretschneider reports two cases, one with primary carcinoma of the prostate with metastases of the Fig. 4. — Upper end of femur; complete destruction of head, neck, nnd tuberosities. bone marrow of long bones, the vertebrae, and ribs. The second case was osteoma malignum ; carcinoma- tous adenoma nodules in the thyroid lobes, metas- tases in the left femur, and in the pelvis with spon- taneous fracture; metastases of the ribs projecting into the right pleural cavity; metastases at the ribs near the vertebral column right and left ; sero- fibrinous pleuritis on the right side with circum- scribed adhesions ; pleuritic metastases of both pleurae, etc. M. Matsuoka (7) proventil price reviews the literature, cites numerous authors, and adds bibliographical refer- ences, in addition to reporting proventil coupon a case of secondary carcinomatosis of bone in a case where he was un- able to discover the primary lesions. He removed the carcinoma of the left tibia by amputation. Meta.static proventil cost inguinal glands were also found. The patient recovered, but cachexia progressed so that no doubt finally the primary carcinoma will be dis- covered. G. H. Stover (8) reports: A case of a female, aged over sixty years, suspected of chronic osteoarthritis hy order proventil the attending physician. On going out to X ray this patient, Stover noticed a scirrhous con- dition of the breasts. Rontgen examination showed buy proventil online mul- tiple lesions in the ribs, scapular heads, clavicles, and other bones. The people buy proventil were Christian scientists and had little use for M. D.'s. His second case was of a female, aged forty-eight years, confined to bed for months from proventil inhaler stiffness and severe pain in back. Sudden onset of pain followed moderate exer- tion of moving in bed. This pain appeared in right arm. Rontgen examination showed a spontaneous fracture in a typical carcinomatous area in the shaft proair proventil of the bone. Stover made the diagnosis and suggested that an examination would reveal a scirrhous proventil coupons carcinoma of the breasts, which proved correct. He found multiple cellular defects in the clavicles, scapulae, humeri, vertebrae, ossa proventil inhaler coupon innominata,

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