[Reprinted from the American Gynaecological and Obstetrical Journal 
for July, 1895 ] 
A LARGE (EDEMATOUS MYOMA TREATED BY ABDOM- 
INAL ELECTRO-PUNCTURE* 
G. Betton Massey, M. D. 
Mrs. C. M. W., aged forty-five, never pregnant ; menopause two 
years ago. An abdominal tumor was discovered ten years before 
consulting me, accompanied by menorrhagia ; but at this time there 
was no flow, notwithstanding which the tumor was rapidly growing 
and becoming softer. Her general health was decidedly affected- 
rather more than is usually the case with fibroid tumors. 
On March 20, 1891, she placed herself under my care, at which 
time the abdominal circumference was thirty-seven and one eighth 
inches and the upper limit of the growth four and a quarter inches 
above the navel. In size and shape it resembled the pregnant uterus 
at term, and was soft and semifluctuating. The uterine cavity was 
but three inches deep. 
In order to determine the character of the growth, the patient was 
placed under the influence of nitrous-oxide gas, and the needle of an 
aspirator thrust deeply into the growth through the abdominal wall. 
The point apparently entered numerous small cavities, withdrawing 
one and one eighth ounce of a serous liquid, which was sent to Dr. 
Allen J. Smith for microscopical examination. The following letter 
was received from Di. Smith : 
332 South Seventeenth Street, March jz, 1891. 
Dear Doctor : I went over the specimen you left with me very 
carefully yesterday. The clot is, I am quite sure, an ordinary blood- 
clot, and the appearance of muscle or connective-tissue fibers is sim- 
ply given by a peculiar contraction of the fibrin of the clot compressing 
the blood-cells into an elongated shape. Washing the clot and stain- 
ing by Weigert's fibrin stain shows the real nature of the mass to be 
* Read before the Philadelphia Obstetrical Society, May 2, 1895. 
Copyright, 1895, by J. D. Emmet, M. D. 2 
G. Betion Massey, M. D. 
such, and staining by ordinary nuclear stains, as carmine and Bis- 
marck brown, fails to bring out the cellular appearance seen in the 
unstained preparation. I do not think, therefore, that you are war- 
ranted in concluding from this specimen that you are dealing with a 
myoma or a fibroma. 
On the contrary, none of Drysdale's cells are to be found either 
in the mass or in the liquid. 
Taking the whole matter into consideration, I should regard the 
blood as probably accidental, and the fluid from a broad-ligament cyst. 
Very truly, Allen J. Smith. 
In view of the doubt thus thrown on the nature of the growth, 
which, however, I still thought might be an cedematous myoma, I de- 
cided to ask a consultation with Dr. William Goodell with a view to 
sending her to him for operation. This the patient objected to most 
strenuously, resulting in my decision to test the contractility of the 
growth with strong external currents. It was found that such currents 
did cause a temporary hardening and shrinkage, and I therefore de- 
cided to use galvano-puncture by the abdominal method, passing 
three insulated needles at each application through the abdominal 
wall, all connected with the negative pole of the battery. This was done 
on three occasions during the following two months with a strength 
of 65 milliamperes, external applications being also employed. At the 
end of this time the girth was reduced two and one eighth inches to 
thirty-five, and the upper limit was only two inches above the navel. 
From September, 1891, to March, 1893, nine such punctures were 
made varying in strength from 100 to 300 milliamperes, during which 
time no other treatment was used, and a continuous decrease in size was 
noted. Since the termination of the treatment the patient has been 
under occasional observation, and at her last visit, during the past 
winter, the tumor was the size of a large orange only, with general 
restoration of health. 
1636 Walnut Street.