Presenting complaint
Patient history
A 46-year-old woman arrives on the third day of an illness. It opened with violent vomiting and watery diarrhoea that began late one evening, ran for about eighteen hours and then stopped. Yesterday she felt well enough to think it was over. This morning she is nauseated again, sore under the ribs on the right, and her husband says she keeps losing the thread of what she is saying.