In these two delayed cases, progress of the mass could be traced in sausage-like form, rising behind colon till well toward the hepatic flexure before rupture occurred; but except for this delay the history of the entire attack was about the same as other perforated cases.
In no one case of abscess has a recurrence of appendicitis of any type appeared, the abscess and evacuation seeming to have healed the organ permanently, even though it was formerly the seat of many attacks.
In not one case was surgery invoked, as the simple treatment of emptying the colon and keeping the entire digestive tract at rest had borne nothing but perfect fruit; and no occasion ever seemed so desperate as to warrant a surgical removal that could not promise recovery in every case.
Until failures of this expectant plan are met with, it is not strange that the writer has definitely placed the treatment of appendicitis in the non-surgical group of organic inflammations.
NEW YORK CITY.
