348 Diseases of Bone. 



lift as heavy a weight with the left arm as with the right, and 

 even to the last stage, that in which I saw him, his hand was 

 strong to grasp. In the first four months the upper part of the arm 

 had so increased in size that the prominent part exceeded the size of his 

 head, but now, at the end of nine months, it greatly exceeds in size his 

 emaciated bod}'. 



' ' When I went to receive this poor lad, I found him lying deep in the 

 hold of a small sloop, in which he liad been transported from Inverness, 

 laid on a coarse mattress, and bolstered up against the shelving side of the 

 vessel ; and when the clothes were lifted I solemnly declare that I hardly 

 knew at first what it was that I saw — which was the tumour and which 

 his body, or how to connect in imagination the one with the other. He 

 lay in an inclined and irregular posture, extremelj' languid, and hardly 

 able to articulate, his head inclining to one side. The tumour, when first 

 exposed by lifting the clothes, might be mistaken for his body in respect 

 of size, it was of a suitable bulk, and when the lean, yellow, emaciated 

 thorax was next exposed, the tumour seemed so much to exceed it in size, 

 with a shining surface and brilliant colour, that at first I was more 

 confounded than shocked, so impossible was it, in the first moments, to 

 consider of it as a tumour, or to see its relation to the arm. The forearm 

 was dwindled and shrunk, and projected from the tumour at a strange and 

 unnatural distance from the shoulder. The veins were swelled, like these of 

 a horse's belly ; large fungous tumours, as big as oranges, projected in a 

 group from the outside of the arm at the place where, about two montlis 

 before, a large abscess had burst ; and such was the foetor of the matter 

 running from under these fungi and the languor of this poor emaciated 

 creature, that I had no thought for the present but how to get him 

 conveyed alive to town. After a few days, when he was somewhat 

 recovered from the fatigues of the voyage, I proceeded to write down the 

 history, and examine the actual state of this tumour. I found it througli- 

 out solid, consisting chiefly of bone, little cartilaginous, hardly in any 

 part elastic or yielding, and discharging matter, not from any superficial 

 abscess, but apparently from the centre of this enormous mass. I had 

 every reason to believe that the bone and the joint, which certainly were 

 neither broken nor dislocated, had been generally injured, not merely by 

 the shock but by the bruise ; that the parts nearest the bone, and 

 connected with it by the periosteum, had been bruised and inflamed ; that 

 the extreme pain for the first twenty-four hours indicated only the 

 violence of the immediate injury, but the slow vascular action which 

 succeeded at the distance of a month pi'oved how deeply the circulation of 

 the bone was afi"ected, and caused that osseous secretion which generated 

 this prodigious shell of bone, while the shaft of the shoulder-bone, from 

 the periosteum of which this callus had been secreted, was in part 

 destroyed by an ulcerating process within. That the ulceration, deep- 

 seated, not only in the bone but in the joint, occasioned those excruciat- 

 ing tortures which were announced by wild and desperate cries night and 

 day ; that the matter, bursting at last through every obstacle, had made its 



