be made comfortable in three days.

Just why diagnosing a perityphlitic abscess should have cleared the
diagnostic atmosphere to such an extent as to justify one in
declaring that, _since the discovery of the abscess there could be
no doubt of diffuse peritonitis, _is hard to understand. According
to my training in the worth of differential diagnosis, I should look
upon such a diagnosis as most excellent proof that the peritoneum
was still intact, and, if the case were handled carefully, its
_intestine sacredness _would remain free from the vandalizing
influence of toxic infection.

I am not inclined to accept the diagnosis, for within twenty-four
hours the abscess broke into the cecum, and if the case had advanced
to perityphlitic abscess, the pus would have burrowed downward
towards the groin and would not have terminated as early as it did.
My reason for so believing is that we always have a typhlitic or
appendicular abscess at first; which naturally opens into the bowel,
but if the abscess be interfered with--handled roughly enough to
rupture the pyogenic membrane--the pus is forced into the
subperitoneal tissue where it may gather and become encysted, but
this is exceedingly doubtful. When the pyogenic cyst is once broken
the pus becomes diffused, and as it has no retaining membrane it
burrows in all directions, and more or less of it is absorbed,
causing pyomia.

The parts may be handled to such an extent that the abscess will be
forced to develop low down toward the groin, so low that the natural
outlet, through the intestine, will be impracticable; under such
circumstances an outside opening with drainage is the only choice in