A Request for Diagnosis.
Editor Ellingwood's Therapeutist:
Can you or any of the brother physicians of THE THERAPEUTIST family help me concerning the following described case: A lady, age 45, complains of pain which is generally dull but occasionally sharp and lancinating confined to the epigastric region except when she has been out riding. At that time she complains of a severe aching between the shoulder blades. She vomits at almost any time. Quite frequently in the middle of a meal she will have to leave the table to vomit.
The menses are regular and normal, the temperature is normal, the urine is normal. The bowels are slightly constipated. She began complaining two years ago last March at which time she weighed 205 pounds. In less than three months she fell off 65 pounds. She has lost no weight since that time. She is five feet six inches tall.
In April, 1907, the abdomen was opened, the appendix was removed and the gall bladder was examined. To all appearances these organs were in a normal condition. She has not the characteristic cachexia of cancer. A recent examination of the contents of the stomach showed that there was an entire absence of hydrochloric acid, and an abundance of lactic acid. A microscopical examination of the blood gave us no light on the subject. I hope I have described the case sufficiently in detail, to enable some of the readers to give me a diagnosis and suggest some measures that will cure the patient.
A. W. DORTCH, M. D.