History. —Mrs. A. S., aged 75, living in Hoboken, N. J., came to this city seeking relief for her distressing condition. Patient had had ten children. Her rupture appeared while she was in Europe, and she was operated on there five years ago. The operation gave relief for two years, when the hernia again recurred, but did not give her much trouble because she could easily reduce it. It had grown steadily, and for the last four months she was unable to replace it. At the time she was seen it caused her much annoyance and pain, especially while walking. Examination. —A large tumor painful to the touch and about size of a cocoanut was seen on the right side below Poupart's ligament. Over the tumor there was a linear scar two and a half inches long. As the hernia was incarcerated and there was no hope of reducing it