—H. J. F., male, aged 18, stenographer, was referred by Dr. G. A. Speer, Sharpsburg, Pa. There is nothing bearing on the disease in the history previous to April, 1907, when the patient had an attack of acture appendicitis, for which I operated and found a gangrenous appendix with a large abscess. The appendix was removed through a gridiron incision, a cigarette drain and some gauze being used for drainage and the wound partly closed by sutures. The drainage was left in for several days and the wound allows to close by granulations; the process was completed in about six weeks without any unusual features. From that time until the present illness the patient enjoyed excellent health, with entire freedom from pain, bowels moving normally and regularly.
—On April 15, 1909, the patient