CLINIC.\L ARTlCLES.

indulge too freely; he soon left off eating them, and could not be tempted to eat more, although he had at first gone ravenously to work and brought on a fit of vomiting,

I 5 tit fllf.y.-The owner sent us a message to have him destroyed the next day, as we did not think there could be any cure.

Autopsy.-The intestines were removed and found to be normal. The stomach was left in situ, with the animal on its right side; traced the cesophagus from the fauces to the entrance of the thorax, and found it normal. Sawed away the left ribs, and excised the left lung, which brought into view a large dilatation of the cesophagus, imme-

A. CEsophageal orifice of stomach. B. Stomach (inch,e(l along Its gt'eat curvature and emptIed of it~ content~). C. lE'5ophageal pouch. D. Duodennm.

diately in front of the diaphragm. Further examination showed that the walls of this dilatation were composed of the mucous and pleural coats of the gullet. The former had been thrust out of a rupture of the muscular coats measuring about 5 inches long, carrying with it the pleura. The sac had a circumference of 12 inches at its narrowest part, and it contained I ~ lb. of ingesta in a partly fermented state.

The accompanying figure, which has been prepared from a photo­graph, will serve better than any description to convey an idea of the situation, shape, and dimensions of the sac.

A CASE OF LYMPHO-SARCQMA IN THE SHEEP.

By ALEX. M. TROTTER, M.R.C.V.S., Edinburgh,

THIS subject, an aged Cheviot ewe, was consigned by a shire flockmaster to an Edinburgh live-stock market. disembarked at Leith it was observed to be showing

Caithness­On being the usual

C Ll l{ JC.~ L .\RTlCLES. 3~9

symptoms of ill-health, a nd under these circumstances it was deemed advisable to have recouro,e to immediate slaughter. On an autopsy bein g made the carcase was found to have been particularly well­nourished. The flesh presented all the characteristics of good quality, and would have been classified in trade parlance as .. prime." Rigor mortis was well marked. On examination the lungs, heart, spleen, and kidneys were found to be unaffected by the disease.

The liver, which was increased in bulk, dark brown in colour, and firm in consistency, showed numerous nodules of a creamy white colour scattered over the surface. They varied in size from a pigeon's egg to that of a millet seed, and on manipulation were found to be firm and resistant. For the most part they were but slightly raised above the surface of the liver substance, but a few on the diaphragmatic surface were lying free in small depressions caused by the removal of the liver parenchyma. the bond of union being by a pedicle. The capsule super-adjacent to the neoplasm was t ense and glistening. On making an incision into the liver these nodules were found scattered irregularly throughout its substance, they had a firmer consistency than that of normal liver, and when cut they had a well-defined edge. Their border was sharply defined and their structure appeared to be homogeneous.

Members of the mesenteric, hepatic, lumbar, internal iliac, external iliac, and sacral groups of lymphatic glands, were more or less affected by the disease. Some of these glands were uniformly enlarged and showed the typical outline to perfection. Others, however, had coalesced, and formed the neoplasm to be described below. The glands were of a white colour, and the capsule was tense and translucent, In consistency they were softer than normal, but still their density was such as to permit of their being cut with a well-defined edge, The cut surface, which was of a similar colour to the exterior, was smooth and homogeneous in appearance.

NcoplaslIZ.-At its extreme length the neoplasm measured 34'S cm. , and it extended from the eleventh dorsal vertebra to the anterior extremity of the sacrum. For the purposes of description it will be convenient to divide it into thoracic and peritoneal portions. The latter was much the larger of the t\yO, measuring 25'5 cm. Immediately posterior to the diaphragm it was somewhat constricted, so as to accommodate the superior edge of the liver, but it immediately thereafter assumed greater circumference and obtained a diameter of I 1'0 cm. From this point it tapered irregularly towards its posterior extremity. Near the apex it measured 6'0 cm. To a very great extent the neoplasm was embedded in adipose tissue, to which it was loosely adherent by a delicate network of fibrous tissue. \Vhen exposed to view by breaking down these fine connecting bands, it was found to be of a dirty creamy white colour. The surface was smooth, glistening, and slightly nodular, and the edges were round. It was firm in consistency and cut with a well-defined edge. The colour of the cut section was similar to that of the exterior, and it was distinctly lobulated. In the centre of the mass \"as found the posterior aorta, and close examination revealed that both were intimately connected. No und ue pressure, however, would appear to have taken place, as the lu men of the vessel was normal. On laying the artery open through­out its entire length the Cll1lica illtima ",as found to be intact, and the

350 CLIN1C.\L ARTlCU_>-.

usual branches ",cre given of{ with unimpaired regularity, so that one must infer that the mass of new tissue had become deposited around this great vessel and its branches, without, to any great extent at least, interfering with its usefulness. The posterior vena cava, diverging to the left from its point of origin, emerged from the substance of the neoplasm in the region of the first lumbar vertebra, and was then carried forward on the surface of the mass, to which it was firmly adherent until it reached the anterior fissure of the liver, into which it disappeared to gain the foramen dextrum. Several of the lymphatic glands along the course and in the immediate vicinity of the neoplasm had become affected; these were the sacral, internal iliac, external iliac, lumbar, and hepatic groups. Some of those glands had become part and parcel of the mass, such as those of the sacral and lumbar; others had become affected, but had remained separate and distincI: from the bulk of the neoplasm. On making a transverse incision the pillars of the diaphragm were found to have retained their usual position, and had therefore in a manner divided the lesion into two. Although surrounded on three sides this muscle appeared, so far a~ the unaided eye could detect, to be perfectly healthy. The psoas muscles. however. were found to have become in fllt rated to a con­siderable extent. Here the lesions had taken on the usual characte( of a primary malignant tumour, a nd had infiltrated the surrounciing tissue in such a manner (IS to render it impossible to say when: the diseased tissue ended, and where the healthy tissue commenced.

The thoracic portion was by far the smaller of the t\VO, measuring in length 9'2 cm., with a transverse diameter at the base of 8'0 cm. It was an irregular three-sided pyramid in shape, with the base firmly attached to the diaphragm, through which it extended, being continued posteriorly as the peritoneal portion. Superiorly it was firmly attached to the vertebral column by means of processes which penetrated the intercos tal spaces. The macroscopical characteristics were similar to those already described as pertaining to the peritoneal portion. The fibres of that part of the diaphragm intersecting the mass presented on transverse section a very peculiar appearance. Radiating from innumerable centres throughout the whole surface were fine tortuous septa, and these anastomosing with the arms of other centres pre­sented the appearance of a fine network, the meshes of which were most irregular both in regard to shape and size. Longitudinally the normal muscular fibres werc intermixed with paler bands of varying size. these corresponding to the centres observed on transverse section.

lIIicroscopical EXtllllinatioll.-0n microscopical examination the neoplasm was observed to closely resemble in structure a lym­phatic gland. being compo~ecl of cells similar to those of a small round-celled sarcoma, lying in the meshes of a delicate fibrous reti­culum. The most typical specimens of a lympho-sarcoma were obtained from the older portions of the neopl asm. Here the intercellular matrix was in grea ter abundance, and the cells differed from those (If the small round-celled sarcoma in having a less promin­ent nucleus. In the younger or more actively proliferating parts of the neoplasm this distinction was not so much in evidence, the nuclei of the cells being very pronounced. and the fibrous matrix cOllsiderably less abundant. This tends to strengthen the contention of CorniJ and Ranvier that certain of these cells ha"e the pO\\'cr of reproducing

.\BSTRAC fS. 35 1

fibrous tissue. In mallY centres the tissues of the primary neoplasm were found to be undergoing myxomatous degeneration. As is usual with this form of degeneration, the parts chiefly affected were in the immediate vicinity of the blood-vessels, but small isolated irregularly angular spaces were also frequently met with. It may be interesting to add that although this degeneration was generalised the lesions were so minute as to be unrecognisable by the unaided eye.

The secondary tumours in the liver had a similar structure.

TUBERCULOSIS IN MASSACHUSETTS.

IN the June No. of the Journal (p. 174) an account was gi\'en of the measures that had been brought into force with the object of stamping out tuberculosis in the State of Massachusetts. These measures were introduced by the State Board of Cattle Commissioners, who under a law passed in June 1894 were given very extended power in dealing with tuberculosis.

Up to that time animals were condemned by physical examination alone, but in September of last year the Commissioners decided to use the tuberculin test in place of physical examination. In order to do thi~ it was felt that not only should anImals, as reported by.the several inspectors, be tested with tuberculin, but that systematic regulations should be adopted throughout the State providing for the quarantining of all animals until tested; for regulating the importation of all animals from without the State; for providing a market at which tested animals might be procured by those desiring to have them; and, lastly, for the regular and systematic examinatIon of all neat cattle throughout the State, and the destruction of all animals that reacted to the test.

The system adopted by the Commissioners for the carrying out of these ideas embraced :-

First.-The test with tuberculin of all suspected cases reported by local inspectors.

Secolld.-The regulation of the importation of all neat stock into the Commonwealth from all points without Its limits.

Tltird.-The quarantining of all such imported animals until tested with tuberculin, and either tested or certified as sound.

FOltrtli.-The establishmen t of regular quarantine stations at which ali animals brought within the limits of the Commonwealth should be delivered in quarantine.

Fijllt.-The forbidding of the importation of all neat stock within the limits of the Commonwealth unless delivered at these points, except upon written permit of the Board.

Sixtli.-The branding, in a distinct way, of all animals that had 5uccessfully passed the tuberculin test.

Sez'mtli.-A systematic examination, by the use of tuberculin, of all animals within the State, beginning with the counties of Nantucket, Dukes, and Barnstable.

This policy of the Board was first made public at Worcester on 25th October, 1894, and came into force one month later, on 25th November.