VIII. B, 2 Gilman: Appendicitis 149 



in every case of abdominal trouble not clearly due to something 

 else, we shall be in a position to relieve a large number of 

 patients who heretofore have drifted from one physician to 

 another. Too often these patients tell of various diagnoses by 

 different physicians and of long courses of treatment for dis- 

 orders attributed at different times to various portions of the 

 alimentary canal. 



Appendicitis as met with in the Philippines presents, among 

 both the Filipinos and Europeans who have resided here for 

 long periods, certain differences from the cases usually met 

 with in the United States. This disease is not always a simple 

 matter to diagnose nor, if a diagnosis has been made, is the 

 condition of the appendix and neighboring peritoneum always 

 an easy question to determine. In many cases pathological 

 changes occur which are out of all proportion to the clinical 

 manifestations. 



