Syphilitic Granulomata of the Uterus and Appendages in a Child of 8 Years

was complaining of severe pain in the lower abdomen with vomiting and rise of fever to about 103?F. This was not her first attack, as she' had had similar ones three or four times before. On examination, her respiratory and urinary systems were normal, and no history of syphilis or tuberculosis could be obtainable. Abdominal palpation revealed a distinct mass in the right iliac fossa, painful and tender. The liver and spleen were normal, and no other glands were enlarged anywhere else in the body. There was no history of chronic constipation or of rectal irregularity. The patient was kept under observation for a couple of days, during which time the temperature came down to normal, but the pain and vomiting remained. I made a provisional diagnosis of tubercular caecum, and decided to remove it. On making a right rectal incision and opening the peritoneum,