NARRATION OF CASE.
—Mrs. R., age 65, referred by Dr. W. F. Malone. Usual diseases of children. Appendicitis three years ago. Full recovery. Thirteen months ago loss of appetite and loss in weight. Family history negative.
—Weight 52 kilo. Emaciation and weakness very marked. Almost complete anorexia. Dull continuous pain over gastric region; slight tenderness over region of the gall bladder. This is only elicited at intervals. Stiller's sign absent. Abdomen is distended to the utmost in both the gastric and umbilical regions. Ten c.m. below the umbilicus the resonance of percussion takes on a lower pitch. (Percussion from above downward.) No stool the last ten days. Patient vomits continually, which consists of a foamy, brownish, malodorous mass, made up of fermenting food remnants. Total absence of HCl free or combined. Presence of an immense number of sareinæ. No Oppler-Boas
BECKER W. PRIMARY ENDOTHELIOMA OF THE GALL BLADDER.. JAMA. 1903;XL(14):903–909. doi:10.1001/jama.1903.92490140019001f