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JAMA. 1910;LIV(6):461-462. doi:10.1001/jama.1910.92550320009002m.
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History.  —E. I., aged 35, married, came to me with a large tumor of abdomen. The patient's mother had borne eight children. The patient had always been healthy up to time of present illness. She had none of the usual diseases of childhood; her weight at 15 years of age was 180 pounds. She was the mother of four children, the eldest 16, the youngest 10 years of age. Between these children twins were born, who lived to be 8 months old. The patient had been married seventeen years.

Present Illness.  —This began in June, 1907, at which time the patient thought she became pregnant, as she had cessation of menstruation, nausea and fainting spells. In August, 1907, she had slight return of menses and pain in abdomen. At various times during this month pain in abdomen was quite severe. Her digestion was exceedingly poor. In November, 1907, she


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