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The point of greatest importance is that a diag-tT»18°f aPPcnclicitis should not be based on any one symptom, 'ci'e is no such thing us a. pathogiiomonic symptom of appenicitis. Pain in the region of the appendix may mean some-">g else. Not long ago a physician made a diagnosis of l'l'eiidicitis for a man who was traveling in the East and urged "»mediate operation. The patient returned to St. Louis at ice, suffering great pain at the classical point. He asked me operate for appendicitis, I had him go to bed in the hos¬ pital. When I saw him in the morning, there was as beautiful streak of herpes zoster as I have ever seen, occupying the lle of pain. Recovery was prompt. As to treatment, I believe in operation as soon as the diags,s is made, unless there is a positive contraindica! ion. In uikincr a diagnosis we must be on our guard, because in the , y hours in young children there may be something else rowing, l have seen three cases recently, in which I was .led by competent internists to operate, and which occurred Children of live and six years, who within a day developed 1 'I'linionia. One of them was rolling around in bed moving , s limb« freely. I examined the child and elicited no pain n the abdomen» I asked for ten hour's delay, and at the end "U|t time the doctor told me the child had an unmistakable tack of pneumonia. First, make a careful diagnosis and "'" act, but never harbor the idea that appendicitis patients Hot die; nor should you operate on the strength of one Jhiptoni or a combination of indistinct, symptoms. When you arc sure of your diagnosis and the patient s 8till in fair condition, operate at once. If you wait until PUs is forming, then you must follow some other plan of treat-"'lit and use your best judgment in selecting the proper time or operation later in the interval. An appendix which has oph inflamed must be removed some time. Du. doux B. Deaver, Philadelphia: We have heard a great ' '"'l about race suicide within the last few years from one of Ur most distinguished citizens, but. there is no one thing that '(tributes so largely to a decreasing population ns does ster-" y, the result of pelvic nppendiculur peritonitis in young girls ami young women.

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