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September 8, 1883


JAMA. 1883;I(9):273-274. doi:10.1001/jama.1883.023900900170001g

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Luella A., American, aged twenty-one years. Was called to see her first at 2 P. M., July 5, 1883. Learned the following history of the case: Had been for some time of a costive habit—bowels frequently not moving for three or four days. Although not feeling very well, she went on an excursion to Spirit Lake, twenty miles distant by rail July 4. The forenoon of the day was damp and rainy, and upon arriving at the lake she was too ill to join her companions in the grove, but lay on the sofa in the sitting-room of the hotel most of the day. She complained to her friends of pain “across her,” and vomited once or twice during the day.

On returning home in the evening, not having had movement of her bowels for two or three days, and the pain across her continuing, her mother gave her a

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