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JAMA. 1910;LIV(10):792-793. doi:10.1001/jama.1910.92550360001001j.
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Patient.  —Mrs. H., aged 34, wife of farmer living in delta.

History.  —There is nothing of note in the family history. The patient had had the diseases of childhood. She began to menstruate at 14, and has always suffered with dysmenorrhea. In 1905 she was operated on for salpingitis and since that time has had leucorrhea. In the past three years she has suffered from indigestion and constipation. In 1907 an erythematous eruption appeared on the right foot and spread up to the knee; it was treated as erysipelas. The eruption soon disappeared, leaving the patient extremely nervous and excitable.

Present Illness.  —With these exceptions she seemed well until April 10, 1909, when I was called and found her suffering from diarrhea of a severe character. She complained of vertigo, dizziness, and great pain over the right iliac region, and extending up under the right breast. Temperature


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