History.
For nine days Mrs. S., aged 53, an Italian who could speak no English, was attended by her physician, Dr. Stack of Hoboken, who could not understand Italian. The main observations made were: Rise in temperature, which, at the time of consultation, the ninth day, was 104 plus in the rectum, with a pulse of 110 and respiration in the twenties. The patient placed her hand on the upper portion of the abdomen, seeming there to locate the distress; examination revealed a rigidity of the recti in that region; pressure caused expressions of pain, which was, apparently, more acute at Robson's point; examination of the chest and lower portion of the abdomen elicited no evidence of lesion. A tentative diagnosis of cholecystitis was made and the patient was removed to Christ Hospital. On the tenth day of the disease rectal temperature had