sent to me a lady, thirty-three years old, unmarried, tall and stout, and seeking advice and relief on account of an abdominal tumor. She had always been well until four years ago, when she noticed mi umbilical rupture caused by pitching hay. On examination of the abdomen, a large, hard tumor was found ; the uterus apparently could be moved independently of the tumor. The abdominal girth was forty-three inches. The aortic impulse could be felt strongly through the tumor. Her menstruation was frequent, but not excessive. The tumor was movable. She had lost flesh in her face and arms, though she was stronger and stouter than most women. Her weight was 203 lbs. and was formerly 230 lbs. On May 10 I saw her again and found the tumor much as before; her weight was six pounds less. On December 2nd her weight had decreased seven pounds more, and as the presence of the tumor was annoying and prevented her from working, I suggested etherization to make out more fully the relations of the growth. During my different interviews with the patient I had said that I was ready to attempt the removal of the tumor whenever she made up her mind that her life was a burden to her, and she was anxious to undergo an operation of considerable danger. A few days afterwards she was etherized, and the tumor was found to be connected with the uterus, but the uterine cavity was not elongated, and it seemed as if the tumor might be removed without opening it. Her family and herself considered the question, and she came to me soon afterwards and said that she had carried the thing as long as she was going to, and desired its removal. On January 2, 1888, I operated. The incision extended from two and a half inches above the umbilicus to the pubes, and 1 took the opportunity afforded to cure the umbilical hernia. I tied and removed the adherent omentum, cut out much of the sac, and when the abdominal wound was sewed up I united the edges of the hernial sac also. The tumor was easily lifted by a corkscrew (a method I learnt from Mr. Tait), and a pedicle about four inches in diameter was secured by the serre-noeud. Although it seemed a beautiful case for intraperitoneal treatment, I did not dare to try it. The tumor sprang from the back and lower part of the fundus of the uterus, and when the pedicle was brought up to the abdominal surface, the left Fallopian tube and ovary protruded through the wound. It was impossible to unite the peritoneum and abdominal wall around the stump accurately, as not only did the ovary protrude but the uterine wall also, so close was the wire to the uterus ; there was a stump but no pedicle ; it was more like the position of a tightly sewn button on a coat. I removed the ovary and more or less of the tube, as they were in the way, and I feared would be strangulated or would be left outside the incision to be covered by granulations. I do not think that two drachms of blood were lost.The tumor proved to be a solid ovoid fibrous tumor weighing eleven pounds. The after progress of the case has been all that could be des...