A 40 years old male complains frequent attacks of diarrhoea, occasional bleeding severe cramping abdominal pain, nausea, fever, chills, weakness, anorexia, and weight loss. He was advised a barium meal study. Here is the X-ray film.

What is your impression?

     Mrs. R., 31 years of age, dark hair, liver spots in the face, mild some what melancholic temperament, disposed to home-sickness, mother of six children, had on her chin an old dark tetter with red pimples. About midnight attacks of fear and trembling, followed by feverish heat; afraid of evil spirits; of being taken hold of by the devil; sleeplessness; only somewhat relieved towards morning. Had a good education; never been superstitious, now she fears she is getting crazy. She has an anxious expression in her face; dark brownish circles around the eyes; throbbing in the pit of stomach, pressure in the region of heart, hard beats of the heart followed by faint feelings, with darkening before the eyes; pulse slow and soft. Frequent headache; desire for salty food; smell of onions before her nose. Catamenia one week too early, with pains in the chest; feet puffed up every morning.

What is your similimum?