His patient was a merchant 31 years old, mine a farmer 42 years old.
There is a difference in these two men, caused by their occupations.
The merchant could not have made the trip to my office as did the
farmer, for several reasons: First, merchants are pampered; they are
not used to discomfort; they are not used to waiting upon themselves
as country men are. When they are sick they send for the doctor; the
farmer goes to the doctor. The merchant has learned the habit of
spending his money and the farmer has learned the habit of saving
his, and perhaps that one statement is enough for the discerning.

The merchant was too sick to make such a trip and he knew it. The
farmer was too sick to make the trip and he didn't know it. This is
the vital difference between these two cases.

The merchant was tympanitic from the first day of his prostration,
which is not usual. On the fourth day his temperature was 104 degree
F., pulse 120 to 136, mind clear but anxious. His lesser symptoms
were about like the farmer's, with the exception that the merchant
had been given more narcotics and presented more of the dorsal
decubitus than the farmer. Laymen, the plain everyday meaning of
dorsal decubitus is lying on the back. In low forms of disease it is
looked upon as an unfavorable symptom. Where much morphine has been
given it denotes prostration peculiar to the drug. My patient was on
his back for several days, because it is impossible for a patient to
stay on either side while suffering from severe tympanites.

On the sixth day the merchant's pulse was 140 and the temperature
101.3 degree F., which proves, if nothing else does, that he did not
have diffuse peritonitis, for it is impossible for a patient to have