the contents of the small intestine into the stomach. The result is
nausea and vomiting which at times are both severe and persistent.
But when it lasts beyond three days it is an indication of a
complication or mistake in diagnosis, providing the patient has been
properly treated.

The abdomen becomes distended with gas if drugs and food are given;
as regards the pulse, there is nothing characteristic about the
pulse rate and the temperature in this disease. Sometimes the
temperature does not go over 100 degree F., but at times it reaches
105 F. The pulse is sometimes so rapid that it is hard to count--due
usually to drug influence--and again it may not go above 100 or 110
beats per minute during the entire attack.

As these patients are nearly always constipated, and suffering from
indigestion, they generally have a coated tongue.

The above symptoms are those relied upon in making a diagnosis, and
especially the first four--pain, tenderness, rigidity, and nausea
with vomiting--which are generally referred to as the four cardinal
symptoms. Some authors give a "characteristic triad," namely: pain
with tenderness of the abdominal wall, fever, and vomiting.

A patient may have pain with tenderness, fever and vomiting, and be
very far from having appendicitis. There is a world of difference in
the importance of pain, the range being from no danger at all to
absolutely no hope. Tympanites may mean a very simple state or an
absolutely hopeless state. To be able to interpret the exact worth
of symptoms means observation, study, reflection--labor and
experience running over years--and a love of work that is not the