366 Diseases of Bone. 



bone. Amputation was now advised, but Mr B. was induced to place 

 himself in the hands of a quack, who applied stimulating plasters to the 

 leg, with a view, he said, of bringing on suppuration, and salivated Mr B. 

 with mercury. At the end of three months this person was dismissed, 

 and the former medical attendant again requested to see the patient. A 

 great change had taken place — emaciation, pale complexion, bad appetite, 

 constipation of the bowels, a quick, weak, and irregular pulse ; the leg 

 greatly increased in bulk and deformity, hard all over, and exquisitely 

 painful. Its surface was irregular in consequence of several large tubercles, 

 round, firm, and elastic, and somewhat yielding to pressure. The 

 colour of the leg is livid and dark purple, and the tubercles of a dusky 

 yellow, some of them superficially excoriated. The tibia, up to its 

 tubercle, is swelled. The knee and thigh are apparently sound, but the 

 inguinal glands are enlarged and indurated, thougli not painful. 



In a consultation with Professor Russell and Dr Thomson, amputa- 

 tion was again judged proper. This was performed, above the knee, on 

 the 4th September last (1827). 



The leg was injected with minute-size injection, and a vertical 

 section made. The tibia nearly in its whole length appeared enlarged, 

 and degenerated into a texture more like the carcinomatous than any 

 other. The tibia at its middle seemed a little bent, as if it had yielded to 

 the weight of the body. All the soft parts, with slight exceptions, had 

 the same marked appearance as the tibia. 



Tlie stump healed in good time. The swelling of the inguinal 

 glands entirely subsided, and the patient, with occasional slight attacks of 

 indisposition, recovered his former health and vigour, A slight irregularity 

 of the pulse remains, which, previous to the removal of the limb, was 

 conjectured to depend on a thickened state of the cardiac valve, and was 

 considered as no objection to the operation. 



The tumour, which is blanched by the spirit, has sur- 

 rounded the tibia, and in its growth outwards has apparently 

 partly infiltrated the muscles, partly pushed them and the 

 tendons before it. G. C. 1035. 



6.412. Osteo-Sarcoma of the Tibia. — Transverse section of 

 the tibia and tumour from previous case — in spirit, illustrating 

 the above. 



This section of the tumour shows its relations and mode of 

 OTOwth even better than the last one does. G. C. 1035. a. 



6. 413. Osteo-Sarcoma of the Tibia.— Macerated portion 



