J. B., a man, aged 74, entered the Massachusetts Eye and Ear Infirmary to be operated on for cataract of the left eye. Operation was performed for cataract, Feb. 3, 1926.
The present illness began during convalescence, ten days after the cataract operation, when the patient began complaining of occasional dull right upper quadrant pain. The pain continued for three days, becoming gradually more severe and radiating to the back and between the scapulae. The afternoon of the fourth day the pain was so severe that it doubled him up. He began vomiting, and continued to vomit practically all night. The next morning he was seen in consultation by a member of the surgical staff at the Massachusetts General Hospital. On physical examination there was very marked tenderness and spasm in the right upper quadrant, so that this whole area was rigit. As the diagnosis seemed clear, and the patient