Mrs. J. K., 34 years old and a native of Norway, was referred to me by Dr. Gibson of Seattle. Her family history was negative and she did not remember having received an injury of any kind in the abdomen. She has two children, aged 16 and 5 years, and has had two abortions, the last two years ago. Her general health had always been quite good, until 1896, when she began to have some indigestion and distress in the stomach, and this gradually increased.
In May, 1897, she had a sudden attack of severe pain in the left side, in the region of the kidney, accompanied by severe nausea and vomiting. The attack was thought by some to be acute pleurisy, but no definite diagnosis was determined on. It lasted about five weeks. A second attack occurred in the latter part of July, diagnosed as some disease of the