one between attacks is less than one per cent, it is
generally the feeling of the profession that, where there is any
appreciable soreness, or tenderness, or liability to attacks of pain in
the right iliac region, in an individual who has had one attack of
appendicitis, the really conservative and prudent procedure is to have
the source of the trouble removed once and for all.

The four principal symptoms of appendicitis are: pain, which is usually
felt most keenly somewhere between the umbilicus and the right groin,
though this is by no means invariable; tenderness in that same region
upon pressure; rigidity of the muscles of the abdominal wall on the
right side; and temperature, or fever.

No matter how much and how variegated pain you may have in the abdomen,
or how high your temperature may run, if you are not distinctly sore on
firm pressure down in this right lower or southwest quadrant of the
abdomen,--but be careful not to press too hard, it isn't safe,--you may
feel fairly sure that you haven't got appendicitis. If you are, you may
still not have it, but you'd better send for the doctor, to be sure.

CHAPTER XIII

MALARIA: THE PESTILENCE THAT WALKETH IN DARKNESS; THE GREATEST FOE OF
THE PIONEER

Malaria has probably killed more human beings than all the wars that
have ever devastated the globe. Some day the epic of medicine will be
written, and will show what a large and unexpected part it has played in
the progress of civilization. Valuable and essential to that progress as
were the classic great discoveries of fire, ships, wheeled carriages,
steam, gunpowder, and electricity, they are almost paralleled by the
victories of sanitary science and medicine in the cure and prevention of
that greatest disrupter of the social organism--disease. No sooner does
the primitive human hive reach that degree of density which is the one
indispensable condition of civilization, than it is apt to breed a
pestilence which will decimate and even scatter it. Smallpox, cholera,
and bubonic plague have blazed up at intervals in the centres of
greatest congestion, to scourge and shatter the civilization that has
bred them. No civilization could long make headway while it incurred the
dangers from its own dirtiness; and to-day the most massive and imposing
remains of past and gone empires are their aqueducts, their sewers, and
their public baths. What chance has a community of building up a steady
and efficient working f