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December 10, 1910


JAMA. 1910;55(24):2060. doi:10.1001/jama.1910.04330240038011

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Patient.—  Early Dec. 14, 1909, I was called to see Mrs. H. W. B. During the previous evening she had been stricken with intense abdominal pain, of sudden onset, the pain continuing with increasingly severe crampy exacerbations at intervals until I saw her. She had vomited twice within six hours.

Examination.—  This revealed an extremely tender lump to the right of umbilicus. It was hard and seemed about the size of a tangerine orange. The patient said that the lump had appeared within the last two hours, and she was positive such condition had never existed before. The right rectus was very rigid and the right lumbar region was also on guard and sensitive. Bowels had moved previous to onset of pain, but not since. Pulse was 100, and weak volume; temperature 98.8 F. There were no urinary symptoms. The patient was frail, and had been a partial invalid for

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