Suppurative Pancreatitis

CLINICAL HISTORY. The patient (R. G. S.) was a man of 55. There was no relevant history of previous illness except a transient attack of pyrexia, vomiting, and diarrhoea in May, 1943. The patient's final illness, which lasted sixteen days, began on 23/7/43 with vague upper abdominal pain. Pulse and temperature were normal, and there were no abnormal physical signs. Two days later the pain became severe, there was some epigastric tenderness, and his tongue was much furred. During the next two days the pain improved greatly, but returned on 30/7/43. For the next eight days the patient had very severe pain in the back and upper abdomen, but examination only revealed a slightly increased pulse-rate, a furred tongue, and sometimes slight epigastric tenderness; the temperature on 3/8/43 was 99.8°F. It was not until 7/8/43 that he first looked really ill. On 8/8/43 he collapsed suddenly, and was dead within half an hour.