JAMA. 1908;L(5):365. doi:10.1001/jama.1908.25310310041002d.
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The following case is an interesting one because of the position of the sigmoid and the failure of the usual rule for finding the appendix, that of following the longitudinal muscular band of the presenting large intestine to its pelvic end:

Patient.  —J. A., aged 35, a lather by trade, was referred to me by a physician in a neighboring town with a diagnosis of appendicitis. The history was the usual one of an acute attack in mild form lasting four days with no improvement. Examination showed tenderness over McBurney's point with muscular rigidity; temperature was normal and pulse 85.

Operation.  —In operating, the gridiron incision was used and the large intestine immediately presented itself in the wound. It was drawn out from the pelvic end, following the longitudinal band of muscular fibers, and search was made for the appendix. The lower end of the intestine seemed so deep in


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