gone and will never return unless the patient is badly handled.

In this case opium and morphine were given; this was very bad
treatment, for these drugs always produce nausea and vomiting,
exactly what was not desired because of the evil effect the retching
had on the forming abscess. It is true that these cases frequently
vomit the first three days after the obstruction, but there is
practically no danger from retching that early in the disease.
Again, the opium masked the case dreadfully; for it produced
vomiting at that stage of the case when there should have been no
trouble with the stomach at all, and induced a tympanites that was
mistaken for the same state brought on by peritonitis.

In this case the doctor was in a mental mist from the beginning to
the end; notwithstanding he was so confident that he knew all about
his patient, that he has given the case a careful summing up so that
it may be put with the medical classics.

The doctor is in error when he gives the name of "Acute, Diffuse
Peritonitis." The case could not have been peritoneal perforation at
the start, for the symptoms do not justify the diagnosis. A
perforation causing diffuse peritonitis so early would have a higher
pulse and temperature, and death would have followed within a few
hours.

I can believe that there might have been an ulcer extending to the
peritoneal covering, and this set up local peritonitis; but there
was not at any time before the fatal relapse, a toxic inflammation
within the peritoneal cavity; hence there was not diffuse
peritonitis, and there could not have been without complete