Case 3 was that of a young woman of 35, whom I saw during an attack of bilious colic. She was screaming with agony when I saw her, and tossing about from one side of the bed to the other. She would not let me examine her on account of the great pain. She was deeply jaundiced, the whole body was of a dusky yellow, and the conjunctiva was yellow with 2 or 3 small spots of haemorrhage in it dotted over either eye.

I at once administered chloroform, and when she was, half under it, gave ½ grain of morphia hypodermically. That evening I again saw her, and the pains were again coming on. She was again given another ¼ grain of morphia and sent to the Public Hospital.

A week afterwards, under an anaesthetic administered by Dr. McIntire, the usual incision was made, and the gall bladder and ducts exposed. Three small facetted calculi were removed from the gall bladder and one from the common bile duet. The common bile duct was opened directly on the calculus, which was then removed by squeezing it out. The incision into the duct was then closed by two layers of cat-gut stitches A tube was fixed into the gall bladder and the bladder was then stitched to peritoneum and fascia in the usual way The lower part of the wound was stitched, and no strain of any sort was left round the incision made into the duct. She left the Hospital quite well six weeks after the operation.

This woman had been a martyr to the terrible attacks of biliary colic for the three years previously. Latterly they came on about every month. He life was a misery till after the operation.

The gall bladder was small and shrunken, and its walls were very thick. There were no adhesions except some omentum round the gall bladder. This woman was extremely collapsed after the operation. For 24 hours she had a weak thready pulse, was semi-conscious, and was bathed in a cold clammy perspiration. Strychnine and camphor were given freely, rectal saline and nutrient enemata, every four hours. She then gradually recovered from the shock of the operation.