Medical Notes. 603 



sometimes crying from, the pain. In some cases, after 

 shifting about for two or three days, the pain would locate 

 itself apparently about the umbilicus, and very little ben- 

 efited, and in no case permanently, by administration of 

 opiates ; thirst in nearly all the cases, in some it was ex- 

 treme, the patient suffering from it. At times the taking 

 of the smallest quantity of water induced eructations al- 

 most immediately, and increase of pain. Fever present in 

 most of the cases, increasing or appearing only at even- 

 ing. In some there was no distinct febrile manifestation. 

 Urine high-colored in all the cases; conjunctiva yellow, 

 sometimes early in the attack, generally more pronounced 

 as the patient began to recover from his pain and thirst ; 

 vomiting frequent, persistent, not permitting remedies to 

 rest on the stomach, the vomited matters consisting of bil- 

 ious-looking fluids, and sometimes, apparently, pure bile. 

 When there was no decided fever in the case, the pulse 

 was perfectly natural. Flatulence supervened early, most 

 difficult to relieve, and frequently the cause of severe pain, 

 eructations being attended with momentary relief. As the 

 cases became relieved of their acute symptoms, there su- 

 pervened an icteric condition of the surface, with slight 

 headache. Convalescence has been very tardy, it being 

 difficult to restore the appetite, every thing being unpleas- 

 ant to sight and taste almost. 



In the first two or three cases, the symptoms, which 

 seemed to be neuralgic partly, would have almost led one 

 to believe in the presence of lead poison, so nearly were 

 the features allied for a time, had there been any possible 

 way for such a cause to have been assigned. In tlie very 

 large majority of cases there were prodromata — anorexia, 

 languor, ill-defined headache, sluggishness of the bowels, 

 and slight discoloration of the conjunctiva. 



Atnong the most common of the painful complaints of 



