In general, the diagnosis of appendicitis is not difficult to-day. Scarcely a decade and a half ago we were either losing the severe cases as acute peritonitis or inflammation of the bowels, or nursing them through the more protracted stages of typhlitis or perityphlitis, while the mild catarrhal cases were regarded as attacks of cholera morbus or congestion of the bowels. To-day the laity are almost as alert as the practitioners to recognize even the premonitory symptoms.
When we meet exceptions to this rule, the case is apt to be one associated with or simulating disease of the pelvic organs in the female. A case in point is one which was brought to my attention recently. A young girl of about sixteen years of age, healthy in appearance, but nervous and slightly anemic, suffered from recurrent attacks of pain and soreness in the lower abdomen. These attacks occurred every three