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November 4, 1911


JAMA. 1911;LVII(19):1535. doi:10.1001/jama.1911.04260110035017

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History.  —Miss X., aged 22, has for the past three years suffered from attacks of nausea after meals with occasional vomiting spells; at times the nausea has existed irrespective of the ingestion of food. Associated with this condition she has had epigastric pain and obstinate constipation. Menstruation all the usual antidyspeptic remedies without avail. Symptoms for the above conditions by several able physicians who have triethe above conditions by several able physicians who have tried all the usual antidyspetic remedies without avail. Symptoms and signs included slight epigastric pain on deep pressure; distinct pain over the region of the appendix on pressure. A diagnosis of chronic appendicitis with epigastric symptoms and constipation preponderating. Operation.—Numerous adhesions in the region of the caput cecum were at once encountered, i. e., between the cecum, colon, and right lateral parietal peritoneum; between the small intestine and the large bowel, especially in the

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