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Arch Surg. 1935;30(4):584-606. doi:10.1001/archsurg.1935.01180100030004.
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The usual conception of the clinical syndrome evoked by carcinoma of the pancreas and the accounts of this condition ordinarily given in the textbooks of medicine and surgery picture it as essentially one of intense progressive obstructive jaundice with rapid and extreme emaciation. The malady is most often painless, although occasionally there may be epigastric pain, which is apt to be of the paroxysmal type. When in addition to the aforementioned clinical findings, discovered in a patient during middle age or late in life, a distended gallbladder can be palpated, then, in accordance with the well known law formulated by Courvoisier, the existence of carcinoma of the head of the pancreas is almost certain.

In spite of the fact that this disease is not infrequently met with in the large teaching hospitals of the country, various statistical studies showing that it comprises between 1 and 2 per cent of all


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