side of the abdomen. It is paroxysmal and caused in the main by
peristalsis--the regular action characteristic of the sewer function
of the bowels, which is for the purpose of forcing the contents of
the intestines onward to the outlet, and which ordinarily is carried
on without pain; but, in bowel obstructions of any kind, the onward
flow of the bowel contents is cut off resulting in great pain where
there is much irritability, for irritation of any kind always
increases this expulsive movement. Food, taken in health, stimulates
this contraction and if taken when there is inflammation--enteritis,
colitis or inflammation of any part--the contraction is increased
and necessarily painful. Think of the pain that the subject of
diarrhea has, then imagine what that pain must be if there should be
obstruction so that the fecal matter could not pass. That is as near
as I can describe what the pain of appendicitis is. Anything that
will stimulate these contractions will throw the patient into great
distress. Food or drugs will cause pain, and water, the first few
days of the illness, will do the same.

In inflammation of the cecum, where the inflammatory process remains
local and there is no obstruction more than constipation will make,
the patient will be troubled with occasional attacks of pain which
will pass as colic; or there may be a diarrhea, lasting for a day,
every few weeks or months with constipation between the attacks.
These cases may lead in time to ulceration, then to fecal abscesses
and they are often diagnosed chronic appendicitis.

When the inflammation is confined to that portion of the cecum that
gives attachment to the appendix there may be no pain, or the pain
may not be intense, and because of this lack of intensity, the
patient tolerates abuse in the line of drugging and feeding until an