In January, 1900, Miss S. presented herself to me complaining of severe and almost constant pain in the right iliac region, and also of persistent constipation, which latter condition at times amounted to obturation. The previous history was negative, the patient having no memory of former illness, nor of intestinal or other disease. The present trouble dated back three years, the pain, constipation, and tendency to obstipation having been the only symptoms complained of. At the time of my first examination she was anemic and slowly losing in weight, but otherwise appeared in reasonably good condition. A tumor, about the size of a small orange, indurated, and with no range of mobility, was made out in the right iliac region. The abdominal muscles were perfectly relaxed. In view of these findings and the progressing nature of the symptoms operation was decided upon. An incision was made through the right rectus