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Amputation of the hip with recovery is fast becoming an ordinary operation; at Westminster Hospital in London, there is preserved the right humerus and scapula, presenting an enormous bulk, which was removed by amputation at the shoulder-joint, for a large lymphosarcoma growing just above the clavicle. The patient was a man of twenty-two, and made a good recovery.
He was exceedingly well-dressed. A moment's pause followed his appearance. Then: "Why, it's our old friend, the kid!" cried Jeems. "Don't let me interrupt," begged the youth diffidently. "No interruption. End of round one," panted Jeems. "Glad you came. Bertie, here, was twisting my delicate clavicle most cruelly. Know Hench and Beck there?"
In a case of Sangster, reported by Politzer, although most of the dermoids, as usual, were like fibroma-nodules and therefore the color of normal skin, those over the mastoid processes and clavicle were lemon-yellow, and were generally thought to be xanthoma until they were excised, and Politzer found they were typical dermoid cysts with the usual contents of degenerated epithelium and hair.
At its outer angle it has a shallow cup known as the glenoid cavity. Into this socket fits the rounded head of the humerus. The shoulder-blade is attached to the trunk chiefly by muscles, and is capable of extensive motion. The clavicle, or collar bone, is a slender bone with a double curve like an italic f, and extends from the outer angle of the shoulder-blade to the top of the breastbone.
I examined her and found a frightful sarcoma of the bone, hardly showing upon the surface, but involving the shoulder-blade and clavicle as well as the humerus. A more malignant case I have never seen. I sent her out of the room and I told him the truth. What did he do? Why, he walked slowly round that room with his hands behind his back, looking with the greatest interest at the pictures.
"The human collar-bone is curved. This is straight. There is a groove upon its surface showing that a great tendon played across it, which could not be the case with a clavicle." "Then I must confess that I don't know what it is." "You need not be ashamed to expose your ignorance, for I don't suppose the whole South Kensington staff could give a name to it."
But, tell me, did you find nothing unexpected or suggestive about those bones as to their number and condition, for instance?" "Well, I thought it a little queer that the scapula and clavicle should be there. I should have expected him to cut the arm off at the shoulder-joint." "Yes," said Thorndyke; "so should I; and so it has been done in every case of dismemberment that I am acquainted with.
It may extend beneath the clavicle into the neck, or, extending inwards may form adhesions to the chest wall, and, after eroding the ribs, to the pleura. The usual symptoms of aneurysm are present, and the pressure effects on the veins and nerves are similar to those produced by an aneurysm of the subclavian.
The official theory is that each new decision follows syllogistically from existing precedents. But just as the clavicle in the cat only tells of the existence of some earlier creature to which a collar-bone was useful, precedents survive in the law long after the use they once served is at an end and the reason for them has been forgotten.
'Do you feel like you could eat some ham and eggs, Uncle James? "'Mr. Mayor, says I, after laying my ear to his right shoulder blade and listening, 'you've got a bad attack of super-inflammation of the right clavicle of the harpsichord! "'Good Lord! says he, with a groan, 'Can't you rub something on it, or set it or anything? "I picks up my hat and starts for the door.
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