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obstruction, color returned after application of hot sponges. Died twelve hours later.

Will Rau.-History similar to above. Through and through cut to peritoneum; black peritoneum bulged into wound on opening same, each movement of intestines caused foul dishwater material to flow out. Appendix was post-cecal; ruptured and necrotic in places.

Abscess. Miss A. D. H., thirty-nine years. Intestines matted in right half of abdomen and mass extending transversely to vertebræ, midway between umbilicus and symphysis. This opened and liberated foul colon-bacillus pus, which had dissected beneath mesenteric attachment; traced to right, passed behind cecum, where a pus pocket contained necrotic appendix in pieces; some pieces sloughing tissue removed. Counter-puncture made. Revier, Rochelle, Wilson, Fitzgerald. Septic Nephritis.-Prof. E. R. pendicitis, with septic nephritis.

First attack acute ap-
Appendix found gar-

grenous and ruptured at its middle. Each kidney was punctured and drains left.

Marked epistaxis on first and second day; some bleeding on removal of appendical drain, and from each kidney when drains removed. Died on fifth day.

Septic Cholecystitis.-Sam'l J. Sl. Sixty-seven years. Abdomen distended and tight. All of right side boggy from ice applications. Appendix found markedly congested, and with some adhesions. Gall-bladder contained four stones and five or six ounces black septic material. Drained. Many hyaline and granular casts.

Abscess. Mr. McD. Forty-nine years. Was subject of protracted sprees since a boy; had several pulmonary hemorrhages. Was taken in a drunken debauch, and operated upon the fourth day. Small local abscess opened

and appendix removed. Had an alcoholic gastritis, and vomited until death.

W. T. C.-Abdominal pain and nausea for a week, but remaining up and about until three days before operation, when pain became so severe. Operated June 1. Abdomen flat; foul-smelling pus cavity opened and floating appendix removed, and opening in cecum left. Much mealy fluid escaped on second day; free fecal discharge from wound-wound becoming necrotic-and a diarrhea which continued until death thirteenth day.

Was very superstitious, saying from the first he was going to die. Two brothers before died, each giving up from beginning of sickness; one typhoid, one pneumonia.

Influence on Longevity.-The absurd statements made by supposedly intelligent and well informed people that removal of the appendix shortens life needs only to be met with facts. Not one scintilla of evidence has been or can be brought to sustain such a statement.

All evidence gathered by insurance companies and medical men proves that the chance for long life is enhanced by appendectomy; in other words, the danger of death. from appendicitis is eliminated.

APPENDICITIS RECORD TO DATE, APRIL 16, 1906.
No. Deaths

I Acute, Ist attack; operating during attack. 12
2 Interval, operating after one attack...... 16
́3 Acute (oper. during attack) chronic relaps-
ing...

I

7

4 Acute (oper. during attack), chronic recurring...

6

5 Interval (oper. during interval), chronic relapsing...

139

6 Interval (oper. during interval), chronic re

curring...

.40

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7 Unclassified, belonging to the above six head

ings...

8 Abscess (operating during interval). 9 Abscess (operating during attack). 10 Beginning general peritonitis... II Consultant (no record).

12 Consultant, surgeon (no record). 13 Appendices removed during other operations: class 2...

class 3

class 5....

class 6 ..

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May 10, 1903. Transverse Incision 31 Cases.

Total deaths

10 Cases 355

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Caseous deposit in right kidney
Tubercular peritonitis

Left inguinal hernia, herniotomy.
Ventral hernia, post op. repair
Dermoid cysts of ovaries, D. S-O ...
Right pyosalpinx, D. S-O...

Double pyosalpinx, D. S-O...

Class. No.

Double pyosalpinx, D. S-O...
Cholecystitis, drainage

Gall stones and adhesions

Gall bladder adhesions ...

Gall bladder adhesions and perforation into

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12

Nephropexy, right, and trachelorrhaphy
Nephropexy, right and cystic ovaries ...
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Cystic ovaries, resection and suturing, or S-O.

Cystic ovaries, resection and suturing, or S-O.
Cystic ovaries, resection and suturing, or S-O. 5
Cystic ovaries and intestinal adhesions-tuber-

cular...

Cystic ovaries and retroverted uterus..

Cystic ovaries and hemorrhoids...
Cystic ovaries and double hydrosalpinx-tubes
resected ...

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Sclerotic ovaries. Morph. habitue, D. S-O.. 6
Prolapsed ovary; retroversion, R. O. oophorec-
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Class. No.

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Perineorrhaphy and cystic ovaries...
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Perineorrhaphy and trachelorrhaphy
Trachelorrhaphy and cystic ovaries...
Trachelorrhaphy and cystic ovaries and ventro-
fixation...

Fibroid of uterus, cystic ovaries, and fissure

in ano...

....

Fibroid scirrhous ovaries, and double hemo

salpinx...

Ectopic pregnancy.

Pelvic abscess..

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Curettement...

Curettement and hemorrhoids....

Acute cholecystitis and genl. peritonitis.

Retro-peritoneal abscess...

Acute nephritis; Edebohls...

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S-O, Salpingo-Oophorectomy. R, right, D, double,

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