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1905 Annals of Surgery  
Mrs. R. II., colored, forty-two years of age, was admitted to St. Luke's Hospital, October 31, 1904. The family history was negative. The patient, besides the ordinary diseases of childhood, had suffered an attack of malaria six years previous, and of appendicitis one year later. Her menstrual periods, until recently, were regular and accompanied by some pain. Of late the patient lias bad many uterine haemorrhages, persisting from four days to a week, during which large clots of blood were
more » ... of blood were passed. The patient has bad three normal pregnancies. The condition for which the patient sought admission to the hospital was a mass in the right inguinal region. This growth appeared eighteen years ago, subsequent to the birth of the second child. The patient stated that the mass had always been reducible, but that it would reappear in four or five days after reduction. Eight days previous to admission the mass would no longer disappear on pressure. The patient now became slightly constipated and nauseated. She had emesis twice. There were severe pain and marked tenderness in the region of the mass. By physical examination, it was observed that the patient was well developed and fairly nourished. The expression was anxious and the tongue coated. The temperature was 99.6° F.; pulse, 88; and respiration, 28. The leucocyte count was 13,000. A few dry rales were heard over the entire chest. There was a faint systolic murmur over the apex of the heart. Vaginal examination revealed marked tenderness of the adnexa:; the uterus was enlarged and swollen, and there was a white vaginal secretion. The left tube was swollen, and there was a small hard nodule on the right side of the uterus.
doi:10.1097/00000658-190505000-00009 pmid:17861639 fatcat:gwspguysmbbtjmi533f6fkujhi