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ceased to attract much attention, though it increased in size. When he came under the writers' observation in the following May the swelling was as large as a good-sized hazel nut; it lay in the upper border of the left hypothenar eminence and pulsated distinctly. When pressed upon it creaked faintly, like snow ; and on auscultation a soft bruit was heard. The skin covering it was not discoloured or altered in any way, and there were no discoverable pressure effects. Under local anaesthesia thedoi:10.1016/s0140-6736(00)76088-0 fatcat:7fhzzq352beltaafw6m2nzsmgi