The Differential Diagnosis of Coronary Occlusion and of Cholelithiasis

Until recent years, coronary occlusion has been a diagnosis made only post mortem, for the old teaching of Cohnheim that occlusion of a coronary artery always spells immediate death has dominated the minds of clinicians in spite of ample experimental and clinical evidence to the contrary. Thirty years ago, Porter1showed that ligation of a coronary artery is not necessarily fatal in dogs. This experiment has been repeated many times by subsequent workers, and it is now generally accepted that a dog may live for months after ligation of a coronary artery. In 1912, Herrick2described a group of clinical cases of coronary thrombosis presenting more or less characteristic symptoms, "in which the accident is usually fatal, but not immediately, and perhaps not necessarily so" and may be mistaken for an acute abdominal condition. The close resemblance of this irreparable cardiac injury to a surgical emergency demanding immediate