Mrs. W., æt. 43, was sent to me in September, 1886, suffering from a large abdominal swelling. She gave the following history:—Married 20 years, but had never become pregnant. Health good up to two years ago, when she first noticed a swelling in her left side, and had difficulty in passing water. She also complained of back-ache and pain in the lower part of the abdomen, and was troubled with an offensive brown-coloured discharge from the vagina. Menstruation became irregular and painful, the flow varying in quantity. The swelling increased rapidly, extending from left to light, and filling up the whole “abdomen.” Some weeks before her visit to me she had an attack of inflammation in the abdomen, which seemed to fix the swelling and greatly impeded her breathing.
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