History.—I was called, April 10, 1903, to see Mrs. L., a medium-sized woman, apparently healthy, aged 30. She was the mother of two children, the younger being 2 years old; she had never had any sickness since the diseases of childhood. Her family history was good. She was at about the seventh month of gestation.
Examination.—Her excessive abdominal enlargement was double that of any woman I had ever seen at full term. Palpation was impossible, as the slightest pressure caused excruciating pain. She was unable to assume the recumbent position owing to dyspnea.
Labor.—After being called once by a false alarm, I found her in labor April 20, the contractions being short and of not much force, though she said she had been in labor for five hours. Dilatation had taken place to the size of a silver dollar. Three hours later there was more dilatation. The