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September 2, 1905


Author Affiliations

Professor of Surgery College of Medicine, University of Nebraska; Surgeon to Immanuel and to Wise Memorial Hospitals. OMAHA, NEB.

JAMA. 1905;XLV(10):684-691. doi:10.1001/jama.1905.52510100018002b

Case. 1.  —Miss S., clerk, aged 40, presented herself at the clinic of the University Medical College January 27, 1904, with the following history:

History.  —Family history negative. One year ago she had German measles. Two weeks later she contracted a severe cold which lasted two weeks, and she has not felt well since. She is prone to headaches and becomes easily tired. For past six months she has complained of languor and weariness on slight exertion; also of a nausea, faintness, shortness of breath and occasional sharp pains in her left side near the costal arch. In November, 1903, she discovered an enlargement in the left upper quadrant of the abdomen extending below the arch of the ribs. She was able to continue her occupation, that of clerk in a dry goods store, until December, 1903, when she was compelled to stop it on account of the increasing muscular

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