Besides these tumours a species of an anomalous character is sometimes
met with, appearing to arise from an aneurismal or varicose state
of the venous radicles or capillaries, and partaking somewhat also
of the nature of fungus hæmatodes.[21] I shall detail shortly the
more important circumstances of one case. The patient, a lad aged
sixteen, was admitted into a public hospital on the 7th of November,
1819, on account of a tumour over the left scapula. It was there
deemed imprudent and inadvisable to attempt operation; and, after the
application of leeches, he was dismissed, at the end of eight days.
He then applied to me. The tumour was very large, hard, inelastic,
firmly attached to the left scapula, and extending from its spine over
all its lower surface. It also stretched into the axilla to within
half an inch of the nervous and vascular plexus, and a large arterial
trunk could be felt along its under surface. The arm hung useless,
and, from the wasting of its muscles, was hardly half the size of the
other. According to his own account, the uneasiness produced by the
tumour was trifling when compared to the lancinating and excruciating
pains in the limb. On attempting to move the tumour independently of
the scapula, crepitation was distinctly perceived, as if from fracture
of osseous spicula. A tumour was first perceived about three months
previous, situated immediately below the spine of the scapula, about
the size of a filbert, of a flat form, and attended with distinct
pulsation; it had subsequently increased with great rapidity. About ten
days before his admission into the hospital, it had been punctured;
nothing but blood escaped. It was evident, from the rapid growth of
the tumour, and the severity of the symptoms, that the patient would
soon be destroyed if no operation were attempted. There were no signs
of evil in the thoracic viscera, the ribs and intercostal muscles were
unaffected; though the tumour was firmly fixed to the scapula, yet that
bone was moveable as the one on the opposite side, and the vessels and
nerves in the axilla were quite unconnected with the swelling. The
operation was commenced by making an incision from the axilla to the
lower and posterior part of the tumour. The latissimus dorsi was then
cut across at about two inches from its insertion, so as to expose the
inner edge of the tumour, with a view to tie the subscapular artery
in the first instance; in this, however, I was foiled, owing to its
depth. The dissection was proceeded with to where the branches from
the supra-scapular were expected to enter. In detaching the tumour from
the spine of the scapula, the knife and fingers suddenly dipped into
its substance. This was attended with a profuse gush of florid blood,
with coagula; by a sponge thrust into the cavity, the hemorrhage was in
a great degree arrested; at the same time an attempt made to compress
the subclavian failed, on account of the arm being much raised to
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