Gentlemen:—We went over together last week some patients with biliary disorders showing degrees of jaundice. One of them—Mary Jones, as you will recall — had a history of frequently recurring attacks of cholelithiasis over a period of nine years, but had never before been jaundiced. As her jaundice was rapidly fading, we arrived together at the conclusion that the common duct would be found free.
You saw the patient operated on subsequently by the resident, Dr. Cutler, and will remember that at an early stage of the procedure digital palpation led him to believe that there must be a stone in the common duct. After removing the gall-bladder, which was full of stones, he found that the impression of a deeper stone had been given to the finger by a pancreatic nodule which partly enveloped the lower portion of the duct.
It is well for you to