inflammation of the cecum and, as the history of the ease has
pointed out, was located in that part of the cecum giving attachment
to the appendix, for the autopsy showed that the appendix was
surrounded by adhesions and imbedded in fecal pus. Please note
particularly: The appendix was found in a pus cavity--a
perityphlitic abscess. Why shouldn't the appendix be necrosed?
Located in a field of inflammation, blown up, distended beyond its
vital integrity; why should it not become gangrenous, It doesn't
matter when the perforation of the appendix took place for it is
quite evident that there was not enough disease of the appendix to
cause its perforation until after it had become encased in the
abscess cavity, and if the young man could have been freed from the
treatment he received and could have been given the necessary rest
the abscess cavity would have emptied itself, necrosed appendix and
all, into the bowel and he would have made a perfect recovery.

"The point of rupture closed!" How could a rupture into a distended
gut close, The distention was greater after the rupture than before.
Fresh infection could not take place without a power to force the
putrefaction greater than the force that existed before the abscess
broke into the cecum. Let us reason together: Nature fought
successfully against heavy odds before the rupture. There was gas
distention of bowels interfering by pressure with the circulation
and increasing the area of destruction of tissue; frequent retching
and vomiting interfering by stretching and probably tearing,
threatening disruption to the plastic process that was going on to
close in the disorganizing and necrosing processes; the frequent
examinations, and manipulations for diagnostic purposes, etc., but,
in spite of all this opposition, fatal infection was successfully
resisted; then, after the rupture and discharge, the relaxation, the