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Warren T. Vaughan, M.D.
JAMA. 1922;79(12):966-967. doi:10.1001/jama.1922.26420120001015a.
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Case 1.  —J. B. M., a man, aged 37, was admitted to St. Elizabeth's Hospital, Nov. 8, 1920, complaining of pain in the upper portion of the abdomen, with nausea and vomiting. The illness had begun about October 1, with severe epigastric pain, nausea and vomiting, which were relieved only by the administration of morphin. After the third day the symptoms had been partially relieved, and during the three weeks following, the patient had remained very nearly symptom-free. October 30, however, following two or three days of severe constipation, the abdominal symptoms had returned. Once again they were partially controlled by morphin, but six days later the condition had apparently become critical. The bowels did not move in spite of brisk catharsis. The patient had vomited no blood, nor had he noticed any in the stools. Pain was localized just above the umbilicus, and did not spread to the back,


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