Reports of Societies

1903 Boston Medical and Surgical Journal  
the right sub-scapular region, in 10% to the left sub-scapular region ; and in 20% to the precordia, sternum, right sub-clavicular region or neck (Mur-The temperature chart in biliary infection is characterized by angularity rather than by curves, and by more or less prolonged periods of complete intermission (Murphy). Jaundice is absent in from 80 to 90% of all operative cases of gall bladder or duct disease. Jaundice preceded by colic is practically always due to stone ; jaundice without pain
more » ... undice without pain is practically always due to inflammation or new growths of the ducts, or to outside pressure. The bile in all cases of cholelithiasis should be regarded and treated as an infected secretion. During the presence of a caleulous jaundice, the sudden occurrence of acute epigastric pain, muscular rigidity, nausea, vomiting and collapse, without lencocytosis, strongly suggests acute pancreatitis occasioned by the presence of a stone in the diverticulum of Vater (Murphy).
doi:10.1056/nejm190305141482004 fatcat:jftjji5n45bnxgceeoqdx2gih4