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Mrs. J. J. W., age 48, married 29 years, the mother of eight children, and the recipient of ten severe miscarriages, carriages, came to my office Sept. 1, 1882. She had first noticed this tumor in her breast three months previously. Her attention at that time was called to the swelling in her breast by a small pimple on the surface. Up to this time there had been no apparent change.
A tender enlargement, the size of an English walnut, nut, situated deeply in the inner lower quarter of the left breast. During the past week—for the first time —sharp, shooting, retracting pain, piercing the nipple, had been experienced more frequently.
Menstruation ceased six years ago, without giving rise to any trouble. She had no cachexia, and was apparently in her usual health. On the 18th of September she called again. There was no perceptible increase of the growth, but