[This feeding was the beginning of mistakes for the second round.  If this patient had been left distressingly along until he could have thrown off his opium poison and become normal, and allowed the abscess to drain and close, all would have been well.  This, I assume, would have been the ending if the vigorous examination that was given the patient the day before the collapse had not prematurely ruptured the abscess both into the gut and into the subperitoneal region converting an appendicular abscess into a perityphlitic one.]

“Upon the next day there were several hemorrhagico-purulent stools, the urine was profuse and voided without pain.  Nevertheless, firm, flat resistance was still felt in the lower right side and upon pressure there was lancinating pain no fever.”

[What was the need of this everlasting, eternal, never-ending manipulating to find how much induration there was?  Nothing but harm could come from such senseless officiousness.  The punching, feeling and manipulating of patients without a reasonable excuse is a very bad habit, one that is peculiar to young and inexperienced men.  There is no reason, no object, no purpose in it; it is just a bad habit.]

“There could be no doubt that the perityph abscess had ruptured into the intestine, and that in consequence of this the diffuse peritonitis had at once been relieved.”

[There was no peritonitis up to this time, except the small portion that represented the peritoneal covering of the organ or organs involved in the primary infection.  The peritoneal cavity, or the peritoneum as an organ, was not involved in this disease; hence it is an error to say that there was diffuse peritonitis which was at once relieved by the rupturing of the abscess into the intestine.  It is worth something to know the difference between a drug-created phantom peritonitis and a true peritonitis.  It is not for the sake of controversy that I am taking exceptions to the opinions advanced in this case, neither is it because I delight in criticizing, differing from or finding fault with authority; I have a more laudable reason—­one that I consider humane and justifiable—­namely, to point out to the few who happen to read this book, a safe and life-preserving plan of treating one of the most talked about, and (because of bad—­decidedly bad—­treatment) one of the most fatal maladies of this age.  To do this it is necessary to point out and teach these few how to reason on the subject, and how to weigh with something like exactness the various important symptoms that present themselves under varying styles of treatment.

If a young physician is guided in his opinions by authority—­if he believes that the last word has been said, because he has the last book from the leading authority, and if said authority has not yet learned that there is a true and a phantom diffuse peritonitis, said young man is not in line for saving life; on the contrary, he is liable to mismanage and meet with as great a failure, and be the cause of as unnecessary a death as was the good doctor from whom we are quoting and of whose medical sophistry I am trying to give the true qualitative and quantitative analysis.