Calendar: 1879-1880 Page 662

662 MEDICAL DEPARTMENT IV St in fHefctctut for Commentan pale but well-nourished girl of eighteen gave the following history of her case -At the age of six she had severe attack of rheumatic fever for which she kept her bed for six weeks and slowly recovered-During the last five or six years she has had several attacks of difficulty of breathing and has observed slight swelling of the ankles on many occa- sions especially after much exertion-Six months ago she says the abdomen began to get large-The swelling was uniform but she thinks it began more on the left side where too she had experienced occasional slight attacks of pain and uneasiness The patient is now very weak not thin but extremely pallid -The abdomen measures forty-six inches in circumference at the level of the navel-There is distinct fluctuation but to the right of the navel there is tympanitic percussion What might explain the above facts What help would you expect to get from an examination of the blood and urine and supposing the case to terminate fatally what would you expect to find Give sketches of any appearances you would expect to be present V- bstrtn'c fHeBtctne Describe the management of delivery in patient with deformed pelvis with not more than two inches in the antero-posterior diameter Describe the symptoms and obstetric management of case of "Placenta Preevia State what you know of the causes symptoms and treatment of "Retroflexion" and Anteflexion י of the unimpregnated uterus State what you know of the history and treatment of malignant disease of the uterus