This title is open to criticism, but it serves the purpose of introduction to an interesting observation made by myself and assistants at the Brightlook Hospital, St. Johnsbury, Vt.
Nov. 17, 1913, a girl, aged 8, while at stool was suddenly seized with violent cramps in the abdomen, and in a few moments became unconscious, but rallied soon after; nausea and vomiting followed, relieving her distress. Twenty minutes after this attack, I found her exhibiting exhaustion and pallor. The temperature, 98, was subnormal; the pulse was 100; there was slight tenderness in the right quadrant; the bowels were constipated. Her parents informed me that during the past two years attacks similar to this, though not so severe, had occasioned no anxiety, and that the patient had maintained her usual health though she had complained of slight stomach disturbances more or less during this time. I suspected chronic appendicitis with adhesions,