A CASK OF SARCOMATOUS DISEASE. 



109 



the temperature never rose above 38'4° C. (ioi-i° F.). The patient 

 only ate a part of its food, and was usually dull and sleepy. The 

 respiration was short, and tended to become more rapid. 



A week later a fresh examination gave the following results : 



General condition worse ; muscular wasting more marked ; the 

 bones appeared more prominent ; the coat stared : the lower portions 

 of the limb were swollen ; the heart's action was rapid and strong ; 

 temperature 38-6° C. (101-4° F.) ; pulse 80; respirations 30. Nearly 

 fifty tumours were counted ; all the old ones had increased in size, and 

 a number of new tumours were scattered throughout various regions. 

 We noted — 



On the left side of the body, behind the shoulder and about the 

 middle line of the ribs, two new growths the size of a large hen's egg ; 

 immediately beneath the skin three smaller flattened tumours ; one 

 behind the acromion process ; another in the precordial region ; a 

 third under the girth, near the median line ; nine tumours the size of 

 a shilling to that of a five-shilling-piece formed a string along the 

 hypochondriac region ; over the thin part of the fiank were four similar 

 tumours ; in the inguinal region, especially along the upper border of 

 the internal surface of the thigh, was a chain of tumours, some the size 

 of a pigeon's egg; a large'number of nodules were scattered through- 

 out the connective tissue. 



On the right side were a few small tumours around the large growth 

 in front of the scapula ; along the hypochondriac region a dozen flat- 

 tened tumours, arranged in a string ; in the thin part of the flank, six 

 inches below the angle of the haunch, a tumour the size of a pigeon's 

 egg; in the groin and inner surface of the thigh numerous hard, 

 isolated, or agglomerated nodules ; immediately below the inguinal 

 ring a tumour, difficult to examine, on account of its deep-seated 

 position, but which appeared large in size. 



On the inner surface of the left forearm a subcutaneous tumour as 

 large as a two-shilling piece; nothing on the right limb; nothing 

 about the head or upper two thirds of the neck. 



There was no enlargement of the sublumbar lymphatic glands. 

 Rectal exploration only revealed the presence of a tumour the size of 

 a hen's egg on the anterior margin of the left ilium at the height of 

 the ilio-pectineal crest. 



The temperature was only a few tenths above normal ; the heart's 

 action was rapid and tumultuous, the first sound being strong, the 

 second replaced by a diastolic murmur. 



One morning a few days after this examination, when the patient 

 seemed in the same condition as on the preceding days, and had taken 



