A careful search of the literature at my command has failed to reveal a case of intestinal obstruction in which the symptoms and pathologic findings coincide with the following case:
Aug. 21, 1911, I first saw Mr. B., white, aged 22, laborer. Family history was negative. Patient had had usual diseases of childhood. He had had attacks of severe pains in abdomen with nausea and vomiting at intervals of from one to six months for the past six years. Four years ago his appendix was removed, but this gave him no relief, and one of his attacks came on a few days after the operation. For the past six months these attacks have increased in frequency and severity.
Present Illness.
—About 9 a. m. Aug. 20, 1911, while at breakfast, he was taken with one of his usual attacks of abdomonal pain, he did not eat much breakfast, thinking the pain