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The following case was operated upon by Professor John Ashhurst, Jr.:
Andrew C., aged 42 years, who was born in Scotland and served for a time in the British army, and whose present occupation is that of a gardener, presented himself at Professor Pepper's clinic at the University Hospital with the following history: Eighteen months before his admission to the hospital he began to experience pain running from the throat to the right shoulder and arm, and this continued to be noticed at intervals until six months ago, when he began to be troubled with shortness of breath and complained of a paroxysmal cough and difficulty in swallowing; at this time he noticed a swelling above and a little to the right of the sternum. From this time he suffered much from the symptoms above described, and had also great difficulty in sleeping in the recumbent position and spent a