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I report this case as a contribution to the operative history of gallstones, and that it may be fairly judged. The patient, Miss W., 56 years of age, and of very large frame, was referred to me by my father, Prof. William P. Seymour, for operation, the latter part of February, 1891. The patient, always in good health, and a hardworking woman, began in October, 1890, to have sudden attacks of atrocious pain in the epigastrium. Vomiting sometimes, but not always, accompanied the attacks, which varied from a few minutes to several days duration, with exacerbations. There was considerable tenderness of the epigastrium and liver border during the attacks, and clay-colored stools always followed an attack. At no time was there any jaundice, although the conjunctivae had a slight yellowish tinge most of the time. The urine contained bile after severe paroxysms of pain. Owing to the very much increased