consequence; if the local trouble is of the cecum, typhlitis will
result, and if the local devitalization is in the appendix, brought
on from the irritating effects of a fecal calculus, appendicitis
will result.

These diseases may start in a fulminant manner as suggested--with an
acute intestinal indigestion, which will die down as soon as all the
elements that combine to set off this fulmination l eve expended
their force and unless fresh material be added everything must
settle down to a local trouble. Or if the primary irritation is
subjected to a light form of toxic infection the development of the
disease will be much more insidious and will require much more time
to come to its maturity, or its fulminating stage.

The reason for this is that each person has a cultivated immunity to
a given toxic state of the intestinal contents, and when from
pressure or the irritation caused by a calculus. there is a
denudation of the mucosa the infection that takes place has not the
power to arouse a systemic resistance' but can cause only a local
inflammation; this inflammation may end in ulceration, or it may
cause a thickening of the parts and interfere with drainage from
mucous or glandular pockets; then the locked up secretions become
intensely toxic, and this sets up a new infection much greater then
l the first and powerful enough to cause the system to call out its
militia to put down the rebellion. Now we have fulmination, but if
food and drugs are withheld it ends soon.]

"Severe abdominal pain with tense abdominal walls, fever and
vomiting form the characteristic triad in the first phase of the
disease; less rapidly does meteorism appear. This depends upon