y so than was formerly imagined. The inflammation in the
appendix varies in intensity from a very slight catarrhal or simple
form to an ulcerative variety, and much more rarely to the acute
fulminating appendicitis in which necrosis of the appendix with abscess
formation occurs. It is always accompanied by more or less peritonitis,
which is protective in nature, shutting in the inflammatory process.
Very similar symptomatically is the condition termed perityphlitis,
doubtless in former days frequently due to the appendix, an acute or
chronic inflammation of the walls of the caecum often leading to abscess
formation outside the gut, with or without direct communication with the
canal. The colon is subject to three main forms of inflammation. In
simple _colitis_ the mucous membrane of the colon is intensely injected,
bright red in colour, and secreting a thick mucus, but there is no
accompanying ulceration. It is often found in association with some
constitutional disease, as Bright's disease, and also with cancer of the
bowel. But when it has no association with other trouble it is probably
bacterial in origin, the _Bacillus enteritidis spirogenes_ having been
isolated in many cases. The motions always contain large quantities of
mucus and more or less blood. A second very severe form of inflammation
of the colon is known as "membranous colitis," and this may be either
dyspeptic, or secondary to other diseases. In this trouble membranes are
passed _per anum_, accompanied by a pain so intense as often to cause
fainting. In severe cases complete tubular casts of the intestine have
been found. Often the motions contain very little faecal matter, but
consist only of membranes, mucus and a little blood. A third form is
that known as "ulcerative colitis." Any part of the large intestine may
be affected, and the ulceration shows no special distribution. In severe
cases the muscular coat is exposed, and perforation may ensue. The
number of ulcers varies from a few to many dozen, and in size from a pea
to a five-shilling piece. Like all chronic intestinal ulcers they show a
tendency to become transverse.

Chronic catarrhal affections of the stomach are very common, and often
follow upon repeated acute attacks. In them the connective tissue
increases at the expense of the glandular elements; the mucous membrane
becomes thickened and less active in function. Should the muscular coat
be involved, the elasticity and contractility of t