Mrs. S., widow, aged 63, with negative family and personal history, had, in years past, performed the usual duties of a housewife, and in addition served as farm helper during the harvest season. At the age of 36, in an attempt to lift a heavy forkful of hay on a wagon, she was suddenly stricken with excruciating pain in the middle of the epigastric region and immediately fell to the ground unconscious. She soon recovered, but felt as if she "had been torn to pieces." The pain and weakness persisted for several days and no medical advice was sought. At variable intervals the pain was felt, but on lying down and having hot applications applied to that region the attacks seemed to be aborted.
This state of affairs continued for several years and apparently grew no worse. About five years ago, however, she experienced a severe spell, similar to the