History.
—J. D., male, aged 30, was admitted to the surgical division of the City Hospital, service of Dr. E. R. Haussling, suffering from an acute appendicitis, which he had had for two days. The patient was immediately operated on, and the appendix, which had not ruptured, was removed. A localized abscess developed, which drained well. The patient left the hospital in twenty days cured.
Appendix.
—The appendix measureed 5 cm. in length; its outer two-thirds was triangular in shape, and sacculated. (See illustration.) The dilated portion contained pus, necrotic tissue, fecal matter, and twenty-two shot. The size of the shot was No. 8, and they showed signs of discharge. Microscopic examination showed an acute suppurative inflammation, together with a chronic process. The proximal end presented a thickened and rigid muscularis, which caused the lumen to remain patent and large.It seems probable that the presence of the shot had only an indirect part in causing the present