These cases illustrate unusual phases of intraperitoneal tuberculosis, and serve also to draw attention to certain points in the natural history of this disease which do not appear to have received sufficient notice at the hands of systematic writers.
HYPERTROPHIC APPENDICITIS OF TUBERCULOUS ORIGIN
Case 1.
—History.
—S. R., boy aged 10, had had numerous previous attacks of appendicular colic, and a history of "not feeling well" for one month, with the present acute attack of three days' duration.
Examination.
—Patient was rather pale and emaciated; pain, vomiting, constipation, tense rectus, indistinct tumor at McBurney's point. Afternoon temperature, 102 F.; leucocytosis, 20,000.
Operation.
—Incision over tumor revealed an old chronic appendix of such enormous thickness that it was taken at first for a loop of small intestine. The abdomen contained some clear fluid. The appendix was surrounded by dense adhesions protecting