A CASK OF SARCOMATOUS 1)ISP:ASK. Ill 



great serratus muscle ; thirty below the left shoulder. They were very 

 numerous in the pectoral, abdominal, and costal muscles. 



On opening the abdomen we were struck by the abundance of fat 

 still remaining in the lumbar region, around the kidneys, and in the 

 pelvis. We only found one tumour there, that which had been recog- 

 nised by rectal exploration at the anterior margin of the ilium. There 

 were none in the liver, spleen, kidneys, or bladder : nor in the walls of 

 the stomach or intestine. Dissection showed a few in the interstices 

 of the psosa muscles. 



The pleurae contained a little lemon-}ellow liquid, but showed 

 neither tumours nor granulations. The left lung only exhibited the 

 ordinary lesions of hypostatic congestion. Sections through the 

 centre of the right lung revealed four recent whitish, friable tumours, 

 the size of a nut, but not surrounded by any congestive or inflam- 

 matory zone. 



The pericardium contained a little lemon-yellow liquid. Both its 

 layers were normal : between the external and the mediastinum, dis- 

 tributed in a layer of adipose tissue, were about twenty small flattened 

 tumours. 



The heart showed remarkable lesions. The myocardium appeared 

 slightly h}pertrophied, softened, and pale 3ellow in colour. All the 

 valves were deformed b}- the presence of little flattened biconvex 

 tumours, developed in their thickness ; the largest the size of a sixpence, 

 the smallest of a pea. In general they were closer to the line of 

 insertion than to the free margin ; they were especially thick in the 

 aortic semilunar valves. The diastolic murmur noted during the last 

 days of life had resulted from their interfering with the action of the 

 valves. All were formed of a friable, greyish-white tissue, punctated 

 with fine hemorrhagic spots. 



Finallv, at the base of the heart was a large lesion, which explained 

 both the fatal termination and its sudden character. Astride the 

 bifurcation of the common aorta and closely in contact with both its 

 branches was a large tumour, 8 inches in length, 5 in depth, and 2| in 

 thickness, weighing 2 lbs. 10 oz., surrounded by a number of small 

 satellite new growths, distributed in a layer of connective tissue 

 enveloping the whole. This tumour, which had invaded the tunica 

 adventitia of the aorta, was intimately adherent to the middle coat : 

 the parts could not be separated wiith a director ; it was necessary to 

 use the bistoury. On section, however, the line of demarcation was 

 ver\- clear, the new greyish-white tissue showing up distinctly against 

 the yellow ground of the arterial wall. Like those above mentioned, 

 this tumour could be divided into three zones : a soft reddish tissue. 



