When a stone is passing, the pain will be periodic. When it comes on, it will be excruciating. Between agonies (which means between the rhythms of peristalsis) there remains a feeling of soreness--a tolerable aching, which, contrasted with the greater pain, is insignificant, but which would in time become intolerable, if full relief could not be found.

Pain from stone lodged in any canal--appendix, enteron (intestine), colon, biliary, pelvis of the kidney, ureter, urethra, etc.--is very excruciating, and food increases the pain,

Gastric ulcer is inclined to give out pain when chilled with cold drinks or ice cream. When it is fully developed, pain may be caused by the ingestion of solid foods.

In coming to conclusions regarding an affection, pain is a guide; hence it should never be suppressed by drugs, nor ignored or disputed.

Pain on palpation may be caused from radiation; hence the hands of the physician should be warm, and the temperature of the room should be warm. It should not be forgotten that the personality of a physician may be such as to cause pain. Such surgeons find much excuse for operating.

Facial expression, position of body, tension of muscles, all may manifest pain.

On account of the number of organs and the complexity of the nerve supply, the great variety of functions, etc., the abdomen sends out the greatest variety of pains.

The gastric crisis of locomotor ataxia presents paroxysmal vomitings and severe gastric pain, lasting several hours or several days, which may recur after days or weeks. Other symptoms of tabes dorsalis will clear up the diagnosis, and save a foolish and unnecessary operation for some abdominal affection which happens to fit the particular insanity of the surgeon called. If there were not such senseless operations performed, I should not make such disagreeable statements.

Nephritic crisis (kidney crisis) is caused by a dislocated kidney. The nerves and blood vessels are twisted more or less, and the ureter is flexed. This axial rotation may cause serious strangulation. Where the right kidney is misplaced, the symptoms are nausea, vomiting, pain in the back and thigh; excessive or defective secretion in the bowels, causing indigestion and similar disorders in the renal secretions.

Gas in the bowels frequently causes pain. The gas produces the pain by stretching the peritoneal covering.

Pain at a given point does not always signify that the cause of the pain is located in that region. Absence of pain in regions is often significant,

Pain at the navel is not diagnostic; yet it often signifies appendicular, fallopian-tube, or invagination affections, cancer of the stomach, etc.

If, when pressing the abdominal wall, there is one spot that gives out pain or discomfort, and no other point is sensitive, it is reasonable to believe that the disease is located. When the whole abdomen is sensitive, the pulse is quick, and there is an anxious expression of the face, the disease is peritonitis. If the patient is bright and all attention, and the symptoms appear within a week after confinement, the disease is puerperal peritonitis. When there is no fever, and the pulse does not vary very far from the normal, yet the patient complains at every touch. and the bowels are disturbed with gas, the case is that of trauma, or stretching of the peritoneal sheet, which is made sensitive by toxin poisoning from gastro-intestinal decomposition. This is an affection that is turned aside by a class of physicians as hysteria. Because the patient complains of pressure on one part as much as on another, the doctor decides that there is nothing the matter--just hysteria. Another class will diagnose the case according to the delusion that happens to possess them at the time of examination. It may be fibroid tumor (such cases are liable to have a fibroid); and, of course, the tumor is the cause, and it must be removed. If the doctor's delusion runs to the appendix, gall bladder, floating kidney, enteroptosis, displacement or prolapsus of the womb, etc., etc., the operation selected will be in keeping with his delusion. Is this statement of mine a delusion? I wish it were. These delusions are created and propagated at medical societies. Two or three leading men force their delusions on the rank and file. Medical societies should be suppressed; for they are a menace to society. For a few months after the A. M. A. meetings there is an epidemic of operations, ninety to ninety-five per cent of which are inexcusable, except for the delusions inoculated at the last meeting of the association. Of course, this statement will be pooh-poohed by those whom it fits; but if proof of insanity is desired, surely the inmates of an insane asylum should not be consulted regarding their delusion.

An accumulation of fluid in the abdomen will, on palpation, show flatness at the most dependent point, and resonance at the highest points; whereas an ovarian tumor will show the reverse. In a vaginal examination, with a finger on the vaginal roof and the hand upon the abdomen, the transmitted movements will be felt if there is a tumor; if dropsy, there will be no sensation transmitted. Advanced pregnancy should not be mistaken for tumor or dropsy; yet this mistake has been made by "first class" surgeons.

Arterial pulsations in the epigastric (stomach) region are seldom due to aneurism. To keep from making such an awkward mistake, patients with tension and severe throbbing of the abdominal aorta should be examined daily, and kept on a fast for a few days. If the condition is high blood pressure, the throbbing will soon pass away, and will not return unless overeating or improper eating be indulged in, or sensuality in some form be practiced. The symptom is often found in habitual coffee drinkers.