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The late manifestations of appendicitis are so frequent and so serious that it would seem to me that the discussion by this distinguished body would be of interest and benefit. The question of operation in primary attacks has within recent years received wide consideration at the hands of American surgeons, and the operation has been placed upon a lasting and scientific basis. Witnessing cases which have not thus been operated, together with the serious complications which have succeeded, after apparent recovery from the local disease, I have been further impressed with the correctness of the position which has been taken in favor of early operations. I have recently had an opportunity for conversing upon this subject with a large number of prominent surgeons of Europe, and have repeatedly met the expression that with them in Europe, appendicitis does not seem so serious, nor to demand operation so frequently as has