Abstract

Mrs. L., age 48, was married at 28. Menstruation began at 16. This function continued regularly, painlessly, normally, throughout her unmarried life and during her married life until six months ago, when she began to menstruate on alternate months. She never conceived during her 22 years of married life, though her husband was a healthy man and both enjoyed to the fullest extent the conditions of sexual union. Five years ago, she first noticed an enlargement of the abdomen; she observed that she was short-waisted. Pressure symptoms manifested themselves in disturbances of the digestive system two years ago and were her only annoyance, save the mortification growing out of her abdominal development. There has been no vesical nor renal disturbance, at least so far as the patient remembers, because, like the uterus of advanced pregnancy, it has for five or six years been an occupant of the abdominal cavity. The

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