If this man had been subjected to daily examinations food and drugs, would he have presented the same symptoms!  Indeed the tympanites alone would have killed him.  Was his case diffuse peritonitis? No!  For if there had been intra-peritoneal infection in the first place, it would have indicated perforation, and then, without the opening up of the peritoneal cavity, washing and draining, there would have been a funeral.

The following is a similar case except that the woman came into my hands the first day of her sickness.  Her symptoms were:  Nausea, vomiting and pain all over the bowels as she said—­as much pain in one place as another—­temperature 102 degree F., which ran up to 103 degree F. in the p. m.; pulse 110, and a history of constipation.  She had several movements from the bowels through the night before I was called in the morning.  The movements were small and accompanied with much griping; the patient said that if she could have a good cleaning out of the bowels she felt that she would be well.  I informed her that she had appendicitis and that she would be compelled to remain very quiet in bed, with ice applied locally until the temperature was reduced to 101 degree F., or less, and then substitute hot applications.  For the pain I had her stay in the hot bath until relieved, and when the pain returned she was to go to the bath again.  The bath water was ordered to be used as hot as possible.  Every night an enema of warm water.  The treatment did not vary from the farmer’s and the results were the same—­her bowels moved on the nineteenth day; the consistency and amount were about the same, and I had her exercise care about her eating for a week after the abscess discharged.  From the end of the first week of her sickness until the abscess broke she expressed herself freely that she did not believe there was anything the matter, and that going without food when one felt well was foolish; however, she obeyed and had no suffering.

A son of the woman whose case I have reported above was taken down the same way one year after.  I explained the situation and told the young man that he must keep quiet and go without food just as his mother did the year before.  I did not think it necessary to visit him very often, for he knew how his mother was treated, besides she was with him to advise.

Within three days he was comfortable, and remained so until about the seventh or eighth day, when he decided he would take a glass of milk and not say anything to me about it.  He took the milk and was writhing in pain within two hours.  I was sent for, and of course asked what he had eaten, whereupon he told me that he had taken milk.  Within twenty-four hours he was easy and cured of his desire to eat until ready for it.  This case terminated by rupture of the abscess on the fifteenth day.

Neither of these cases had any tympanites worth mentioning.  All cases that I have ever seen with great bowel distention are those coming into my care after being subjected to the usual feeding and medicating.