Mrs. C., a widow aged 56, white, the mother of two healthy children now aged 22 and 26, had always been exceptionally well and for years had played forty-five holes of golf in one day twice a week. The patient had been taking care of two grand-children who were suffering from typical pertussis. Three weeks before her present illness she contracted a classic case of whooping cough. Frequently paroxysms of severe coughing ensued.
Following one of these attacks during the night of May 12, 1936, the patient was seized with a sudden knife-like pain in the lower left quadrant of the abdomen and was admitted to the Queen's Hospital in Honolulu in profound shock. The pulse was rapid and thready and the entire body was bathed in a clammy sweat. In addition, respirations were shallow and sighing in type, and a tender mass was palpable in the left lower quadrant