Periosteal Sarcomata. 371 



from walking. The swelling varied in size from time to time, and the 

 pain which increased with the swelling was greater at night. It was 

 sometimes sharp, sometimes aching. Blistering was tried without avail. 

 There was difficulty at first in diagnosing between tubercular disease of the 

 knee-joint and sarcoma of the lower end of the femur. The latter, however, 

 was finally decided upon, and on the 10th of September amputation was 

 [)erformed at the hip-joint. Two days afterwards he died. 



The disease seems to have begun in the periosteum, just 

 above the epiphyseal line, and to have spread in all directions, 

 i.e., along the surface of the bone and into the medulla, into the 

 soft textures of the joint, and outwards into the thigh. The 

 disease has extended higher under the periosteum than it has in 

 the medulla. The specimen was injected first with carmine and 

 gelatine, and afterwards with tallow and vermilion, and the 

 latter injection mass can be seen in numerous medium-sized 

 arteries at the margin of the tumour, and also in many places 

 within its substance. G. C. 2807. 



Presented by James Hodsdon, F.R.C.S.E. 



6. 422. Periosteal Sarcoma of Femur and Knee-Joint. — 



Small portion of the femur from the previous specimen — 

 macerated, to illustrate the above. 



The surface of the'condyle, and of the shaft of the femur for 

 four or five inches above it, is rarefied and partly absorbed. Above 

 that there has been a slight but distinct development of the 

 spicular bone characteristic of ossifying sarcomata. This, as it 

 is traced upwards, forms a porous crust, which fades gradually 

 away, but its margin is distinguishable from the surface above 

 which is that of ordinary periosteal irritation. G. C. 2807. b. 

 Presented by James Hodsdon, F.E.C.S.E. 



6. 423. Periosteal Sarcoma of Femur and Knee-Joint.— Glue 



and glycerine cast of the knee-joint in the foregoing case, before 

 operation. 



The cast shows well the globular swelling of the knee- 

 joint, which rendered the diagnosis at first so difficult. 



G. C. 2807. a. 

 Presented Sy Charles W. Cathcart, F.R.C.S.E. 



