The morning call., 1894-09-30
Notion That Grape Seeds
Cause Appendicitis.
ORIGIN OF THE DISEASE
A Physician Gives Some Interesting
information Upon the
Subject.

BILE disease is caused in most instances by
grape seeds lodging in the vermifnrm ap-
pendiX. that tiny branch of the intestinal
canal that serves no good purpose what
ever in the human anatomy. This notion
is wholly fallaciOus, and it is doubtless
costing graDe-growerS good deal; for it
sensibly affects the consumption of the
fruit.
According TO the best authorities the
disease is generally caused by some hard
fecsl matter. 1t was until recently almost
invariably diagnosed as Inflammation of
the bowels, or peritonitis. Diagnoses are
much better made now than they used to
be, and the disease is catalogued under
new name. A physician who has made a
special study of appendicitis had this to
say concerning the trouble and its causes:
81 have been asked more questions re-
Gently on this very point than on any other
connected with my profession, and it
serves to show to what extent these
groundless fears are carried. In order to
have yOu understand this disorder it is
necessary that | should go somewhat
| deeply into its nature. causes, etc, and
like all things connected with my profes-
sion it is difficult to make it clear t. lay
men because We get into the habit OF using
medical terms almost exclusively. How
ever, will endeavor 10 define them as l
go along.
"Tbe abdominal cavity is lined with a
serious membrane. species OF more or
less elasi ic web. which secretes a watery
animal fluid. The membrane Il called the
DE- ritOu8um, and envelops all the organs
in this cavity, either wholly or in part, and
maintains their relations by means of diff
ferent prOlongatlons or ligamentOus folds.
Like all the ser0us membranes, the peri
tOn9um is sort Of sack without aperture,
except in the female, which covers the
abdominal organs without containing
them within it. The vermiform appendix
is a worm-like sack that hangs from
the intestinal canal, known in medical
parauce as the coecum. There is wide
difference of opinion among the embers
of the medical profession on the question
OF the functions of the vermiform ap-
pendiX. What my opinion is is of no value
to yOn; but you can judge for Yourself how
widely opinions differ on this question
from the fact that there are several medi-
cal dictionaries in use that in defining the
term appendix vermlfOrm declare, If my
memory serves me correctly, that its
functions are unknown. Appendicitis
land by the way, this word Is almost al
ways pronounced incorrectly, ci in the
second last sylla BILE should be pronounced
as sigh, not see) or Inflammation of the
vermiform appendix is regarded as the
primary disorder 10 causing Inflammation
in the iescaecal region; that IL, the long
est portion Of the small lntestineS and the
intestinal canal. This Inflammation is
called typhltis, peretyphlitis. paratyDhli-
It's and appendicular peritonitis, or Inftam-
nation of the intestines. Appendicitis in
itself is not so very dangerous. but the
trouble is that the Inflammation in the
vermifOTm appendix may result in its per-
foratiOn and invade the free peritoneal
cavity. Therein the greatest danger lies.
catarrhal a pendicltls, the least dan
gerous form of the disorder, Is believed by
many of the profession TO be caused bv a
micrO-Organism that has not yet besn dis
covered, though it may he caused by an
extension of catarrh of the intestinal
canal. In some few eases it has been
caused by traumatism that's, the condition
OF the organism resulting from wound.
In the great ma 'rity of cases appendicitis
is caused by fecal concretiODs in tho vermi-
form appendix. In exceptional cases a
foreign body is found as a nucleus. These
foreign bodies are generally fragments of
straw, hair, nails, beads, glass and In very
Tary instances grape seeds, cherry stones,
plum stones. etc. There have been cases
where three or four different concretiOns
are found in the same appendix: but as
this question of grape seeds and fruit
stones in general being the cause of this
disorder has often been brought to my at
tention in the past year or so have given
particular attention. and the result has
been that in the last forty odd cases l have
examined or witnessed operated upon the
grape seed has not been the cause in even
one case.
"These concretions first produce a ca
tarrhal inflammation which results in ul-
ceration and often escapes with the in
fammatorv product into the abdominal
cavitv. The result is that the opening.
or Eir-hole. of the appendix Is contracted
by the inflammation, and this action rem
"A. Il, e.
back into the Intestinal canal. The aim
of the physician in the early stages of the
disorder is 10 prevent perfOration of the
veTmitOrm appendix, and if he fears that
perit0nitis may ensue, to give that disease
a plastic character. From the anatomical
structure of the appendix and its relation
to the peritoneal cavity, the profession be
lieve that this cavity is implicated more
or less whenever perfOratiOn occurs. The
perfOratiOn does not, however, in some
cases open into the peTitOneal cavity, but
into loose connected tissue, and it some
times leads to an abscess. In other cases
where perforation does take place in to the
cavity, its extension is hindered by wall
which is composed of the loops of the
small intestines, which have become firmly
adherent
'The most characteristic symptoms of
appendicitis and the resulting diseases are
swelling, localized pain, tenderness and
TlBlGlGy VI Ibe dOuolnludl WALL AS long IS
the disorder is confined to the appendix
the swelling is not distinct and often
eludes detection. Whenever perf0ratiOn
sets in the point or greatest tenderness,
which is ascertained by pressure of the
finger, Is generally the seat of the perfora-
tion. When the resulting disease of pere-
typnlitis begins the swelling increases
rapidly in few days and attains con-
sidera BILE dimensions when the iDflamma-
ton reaches the connecting tissues behind
the intestine canal. Diagnoses are often
rendered difficult by the fact that vomit-
ing and constipation are sometimes promi-
nent symptoms. and II Is then difficult 10
determine whether an inflammatory dis
order in the region of the intestinal canal
Is the cause or simply an intestinal OBJ
stIuction In the same locality
"Autopsies held for the purpose Of de-
termjning the relative frequency of the
disease show that typhlits and the other
resulting diseases are almost invaria bly,
preceded by primary appendicitis. This
fact makes the history Of the case a most
important factor In making a correct dag
D0sis. and it Is also well known that
a person who has once had an attack of
appendicitis, no matter what length of
time may have ELAPSED, is always liable to
subsequent attacks unless the primary
cause is removed by operation. When the
appendix becomes gaDgrenous or when the
perf0ration communicates with the general
peritoneal cavity, then the disease has
Reached its most dangerous state. The
septic material. that is, the material that
produces putrefaction, spreads over the
general cavity, occasions a septic rerito-
nitis and death results in short time.
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