Her physician, Dr. Thomas of Decatur, suspected either ap¬ pendicitis or an ovarian tumor with torsion of the pedicle. Present Condition.-Well nourished, good color, pulse 120 a minute and of fair volume. Temperature, 100.2 F. Abdo¬ men as large as that of a woman at or near term, and regu¬ lar in contour. Physical Examination.-This was quite unsatisfactory on account of extreme abdominal tenderness, which is general. However, a fluctuating tumor can be made out and the uterus seems large and

more »

... s a soft cervix. There is no localized ab¬ dominal rigidity. Diagnosis.-Pregnancy, complicated with ovarian cyst with torsion of the pedicle and consequent peritonitis. Immediate operation advised and accepted. You are fortunate, gentlemen, in having the oppor¬ tunity to see this case, because of the fact that they arc not of very frequent occurrence and for the additional reason that they are, in a measure, emergency cases and therefore not often presented for clinical demon¬ stration. The case, too, is quite typical of its kind and this adds to its practical value. This patient thought that she was unusually large but was not aware that she was the possessor of a tumor until she was told by the physician. Quite commonly these patients regard them¬ selves as entirely normal until the torsion of the pedicle occurs, when an examination leads to the discovery of the tumor. As a result of the torsion, these tumors often