Periosteal Sarcomata. 369 



increased towards night, and also underwent occasionally severe exacer- 

 bations. 



"The lymphatic glands of the groin and of the rest of the body 

 were carefully examined, and found not to be enlarged or otherwise 

 affected. The motions of the hip-joint were perfect, and were performed 

 without giving rise to pain. The limb below the knee was much 

 emaciated. The countenance of the patient was sallow, and had an 

 emaciated appearance, and his tongue was of a bright red colour. His 

 body generally was not much emaciated, and his health appeared on the 

 whole to be good." [The London and Edinburgh Monthly Journal of 

 Medical Science. — Eeport of Case by .John Struthers, Esq., House 

 Surgeon, Royal Infirmary, vol. v., 1845.) 



On 13th June the thigh was amputated at the hip-joint by 

 Dr Handyside by the transfixion method, and the patient made a good 

 recovery ; and six weeks after the operation, i.e. 5th August, he left the 

 Royal Infirmary, with the ligatures still discharging, but the stump other- 

 wise doing well. 



Soon afterwards he complained of occasional frontal headache, fol- 

 lowed by pain in the left orbit and eyeball, with increased sensibility to 

 light and lachrymation. About the middle of August a small chronic 

 abscess formed over the occiput. These pains subsided for a time, but by 

 the end of September had returned with such severity as to confine him to 

 the house. By the end of October Dr Handyside drew up the following 

 report : — " The left eyeball was very prominent and discoloured ; almost 

 complete loss of vision. The eyelids were so much tumefied as almost to 

 conceal the eyeballs, and the veins of the eyelids were very conspicuous, 

 being enlarged and tortuous. The orbit itself appeared to be also enlarged 

 and prominent, especially towards its upper and outer part, forming there 

 a hard, inelastic swelling. These parts were the seat of continual stinging, 

 pain, which prevented sleep, and was fast undermining his strength. 

 Three chronic abscesses were situated over various parts of the head. 

 There was a tumour of the size of an egg on the left hypochondrium, 

 which was firmly adherent to and connected with the cartilages of the 

 upper false ribs. It was slightly elastic to the feel, had grown rapidly, 

 and was the seat of acute darting pains, being, like the tumour of the 

 orbit, decidedly of a malignant character. The disease seemed to be 

 fairly begun in the stump, particularly in that part of it which had been 

 irritated by the long retention of the ligatures, as, at the part where the 

 last ligature had lain, a small pale-coloured fungus protruded. The 

 patient's body generally was emaciated, and his strength was worn down 

 by the continued pain and the malignant hectic. To procure sleep he 

 had been for some time in the habit of taking frequent and full doses of 

 the solution of the muriate of morphia." 



After this he rapidly sank, and died on 11th November, four and a 

 half months after the operation. No post-mortem examination could be 

 obtained. 



The tumour is lobulated on the surface, but has infiltrated 

 2 A 



