382 Diseases of Bone. 



6. 443. Central Sapcoma of the Tibia. — Portion of a tibia— 



in spirit, illustrating the above. 



An infiltrating sarcoma has invaded and replaced the 

 interior of the bone, and has formed a fungus mass on the 

 surface outside. G. C. 185. 



6. 444. Central Sarcoma of the Tibia. — Section of a left tibia 



periosteum removed — in spirit, illustrating the above. 



A sarcoma has invaded and replaced the interior of the 

 bone, near the upper end. G. C. 3104. 



Presented by Macdonald Brown, F.R.C.S.E. 



6. 445. Central Larg-e Round-celled Sarcoma of the 



Upper End of the Femur. — Section of the upper end 

 of a left femur, with portion of tumour and muscles attached 

 — in spirit, illustrating the above. 



The patient, aged 22, a butcher, tall (six feet), and tliin, and seems 

 to have rather overgrown himself. Still, he has been always healthy enough, 

 though rather subject to colds. His family history is good. 



In this end of February 1891 patient had "sciatica-like" pains in 

 the left thigh, chiefly in the knee, and occasionally running up to the 

 thigh. He rubbed in a strong embrocation, and poulticed the painful 

 places at times. On the 6th July the pain became much worse, and Dr. 

 M. was summoned. He gave him some medicine internally, and a lini- 

 ment for the leg, which eased the pain during severe attacks. The pain 

 was intermittent, worse at nights, and at times very severe. It jirevented 

 him from attending to his work. On 13th July he had improved and 

 went back to work. The leg felt stiff, and he limped a little, but the 

 pain was gone as long as the leg was kept quiet. But a slight jerk 

 would cause intense pain, running down the front and inner side of the 

 thigh. On the 13th and 14th July he continued at his work, which 

 required him to be on his feet for nearly the whole day. On the 15th he 

 went to work, but the pain came on in the thigh so severely that he had 

 to go home. Dr. M. ordered rest, and he has remained in bed ever since, 

 rarely sitting up for an hour or two at a time. The pain continued pretty 

 severe. 



On 16th July a little lump appeared on the side of the thigh, about 

 3 inches below the great trochanter. This soon disappeared with rubbing. 

 But at this time the pain was severe up and down the thigh and leg, 

 sometimes into the foot, but always most severe at the knee. 



