Central Sarcomata. 381 



gravity. It, however, passed out of his hands into those of a female 

 bone-setter, who did not improve matters by her attempt to set the so- 

 called dislocation. 



The patient then returned to his first attendant, who sent him to 

 the Infirmary, to be under Dr Joseph Bell's care. It was at once evident 

 that nothing short of amputation of the arm, scapula, and greater part 

 of the clavicle, would be of the slightest use. The tumour involved both 

 supra- and sub-scapular regions, and pressed on the axilla. It was also 

 adherent to the skin of the back. 



The operation was performed, and the boy made a good recovery 

 from it, but died some months after from a return of the disease. 



The tumour, which seems to have grown from the scapula 



near the neck, has spread in all directions, and has infiltrated 



the adjacent muscles. G. C. 2725. 



Presented hj 3 osEPK Bell, F.R.C.S.E., P.R.C.S. 



6. 442. Central Sarcoma of the Head of the Tibia.— 



Section of the upper end of a left tibia — in spirit, illustrating 

 the above. 



Four months before admission to the Royal Infirmary, Edinburgh, 

 the patient — a girl aged nineteen — had felt a pain below the 

 left knee. A swelling appeared, which was blistered without benefit, 

 then poulticed and incised, but only blood escaped. The pain returned 

 nine weeks after the opening had healed. There was by this time a 

 distinct hard lump, which gradually enlarged. On her admission to the 

 Infirmary, on 10th September, the swelling lay midway between the 

 tibia and fibula, about one and a half inches below the level of the head 

 of the fibula, but apparently unconnected with either bone. The swelling 

 was blistered and then incised, but blood only escaped, and the wound 

 thus made rapidly fungated. Amputation above the condyles was 

 performed by Mr. Cathcart on 19th September 1888. 



The patient left the Hospital apparently in good health and spirits. 

 A few months afterwards, however, she became exceedingly peevish and 

 fretful, and, after emaciating rapidlj-, died with symptoms of a cerebral 

 tumour. No post-mortem examination was obtained, but a secondary 

 deposit of the tumour had probably attacked the brain. 



The section shows a soft tumour invading and replacing 

 the cancellous tissue of the head of the tibia and infiltrating 

 the soft textures outside, G. C. 2804. 



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



