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—The first case I have to present is one diagnosed fibro-myoma of the uterus. The patient is 45 years of age. She has borne no children. For several years there has been a menorrhagia developing, which lately has become excessive. Two suspicious symptoms about the case is the disproportionate loss of flesh in the last six months compared to the blood loss, and the almost universal fixation of the lower part of the tumor as I palpate it through the abdominal walls. It extends to just beneath the umbilicus. I should estimate the size of the tumor, including the uterus of which it seems a part, as eight inches in its long diameter, corresponding to the long diameter of the patient, and the transverse diameter at the largest portion at four inches.
—I will make an exploratory laparotomy with the idea of removing the
MARTIN FH, BESLEY FA. SURGICAL CLINIC IN GYNECOLOGY AT THE POST-GRADUATE SCHOOL OF CHICAGO, MARCH 7, 1898.. JAMA. 1898;XXX(25):1439–1442. doi:10.1001/jama.1898.72440770007001c