We must now, however, determine who those persons are in whom such a condition exists. They are those who frequently complain of pains in the appendicular region, usually after quick walking or running, and especially after cycling, and at times even without these; but in this latter class the pain is milder. In order to make an exact diagnosis whether such pains are caused by pressure of the psoas upon the appendix, we must tell the patient to lift the right leg high and we then press with the right hand against the thigh. If there is a latent form of appendicitis due to the above-named anatomical relations, then the patient will experience pain when we press with the left hand upon McBurney’s point. By this means appendicitis can be diagnosed while it is still in an early stage, and the life of many may be saved before it is too late, and we know only too well how rapidly this treacherous disease can lead to a premature death. Having made the diagnosis in the above-mentioned way, we should prohibit all active movements, especially running, cycling, etc., and take special care to have a daily bowel movement by the use of a suitable diet and those other means previously mentioned. Pain in the appendicular region may be of a very pronounced character, and yet there may be no appendicitis, for it may be caused by inspissated fæces. The presence of stagnating fæcal matter often induces the formation of gas, and by the distention so caused the intestinal nerves are irritated and thus pain occasioned. We can distinguish between appendicitis and pains following colics, caused by flatulency, by giving carminatives, such as the decoction of different carminative herbs called Aqua Carminativa Regia, which is much used in Germany and Austria, where it is an official preparation of the Pharmacopœia Austrica and Germanica. A few tablespoonfuls of this decoction will produce free passage of gas, after which, in the case of flatulent colic, the pain will disappear, especially if we add a purgative and clear the intestines. Of course, in appendicitis the pain will not disappear after the use of carminatives. Besides the foregoing very frequent causes of appendicitis there are a few others to deal with, all of which here is out of the question; our intention is to confine ourselves to mentioning some of the more frequent causes and not to deal exhaustively with the subject, which can be found in the various hand-books on surgery. Yet we should like to mention one cause that is not infrequent, and this deals with the relation between the tonsils and the appendix. If we examine these organs histologically, we shall find that both are of the same lymphoid tissue, and, indeed, some writers go so far as to term the appendix the tonsil of the intestine.