The surgical lesions occurring in the abdomen which may assume catastrophic proportions are many; the term "acute conditions of the abdomen" has been employed to designate the group urgently demanding surgery for their relief. Many of them present symptoms of such similarity that preoperative clinical diagnosis becomes a matter of difficulty and at times accurate distinction between them is quite impossible. The common indication in such lesions is surgical relief; this being true, it is apparent that the first duty of the physician in a given case is to determine for or against its employment.
The rapidity with which the disastrous changes in the abdomen develop make it imperative that this determination be made at a time that gives the patient the greatest chance for recovery. Regarded in this light the final differential diagnosis of the cause, though of the utmost importance, must take second place if the mortality from