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November 25, 1911


JAMA. 1911;LVII(22):1762. doi:10.1001/jama.1911.04260110262012

The patient was a woman, aged 25, in good general health, who had been married two years and had no children. Past history was negative, except for a number of attacks of follicular tonsillitis. Two days following an attack of pharyngitis she noticed a swelling develop in the cervical region of her neck. This swelling became larger and gradually extended up the left side of the neck, just posterior to the mastoid process, whence it traveled anteriorly to the submaxillary space and forward almost to the trachea. The mass was very hard and, except for a very small area which was soft and fluctuating, had a board-like feeling on palpation. The skin was not discolored at this time, nor was it adherent to the lump beneath. There was no pain, no rise in temperature, no dyspnea, in fact nothing, either subjective or objective, except the swelling referred to. I saw