The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1885-1921, 1895-04-06

THE APPENDIX.
son happened to have n simian or still
lower grade forefather is sufficient TO make
one wish either that evolution were not
true. or. il so, that useless organs, as in
the case OF the TAIL for example, had dis
appeared when there was no further use
for them in the bodily economy.
Usefulness OutIived.
Unfortunately tho vormiform appendix
of the cRcum was not evolved out OF OK
istence, and in ceasing to be useful 1t be-
came very troublesome. In surviving It's
function as q portion OF the Intestinal
canal it became a menace to health ana
constant source of danger. The danger
was also much increased by the circum-
stance that the symptoms accompanying
disorders of the appendix would direct tho
attention of the physician anu patient 10
other portions of the body rather than TO
the seat OF the trouble. In this disease tho
pain Is usually felt in the neighborhood
of the umbiliCus, next in frequency Is
complained of in the epigastrium, very IN
freoneutly In the region below the UNI
hilicus. and least often of all is it felt III
The appendix itself. This circumstance
has been responsible for many errors
which have been made in determining
the character and location of the trouble.
The inlammatory LESSONS of the appen-
dix were formerly comprehended under
tho terms typhlitis, perityphlitis and para
typhlitis. The first was defined by Albers
rs inflammation of the cecum itself, the
second as Inflammation of the parts i'm
modiately surrounding the cRcum and the
third as inflammation of the postperitoneal
tissaa of the caecum. Grisolle understood
the true pathology OF the disease and pub
lished his views in 1889, but those or Al
bers got into the medical textbooks, and
the correct view was disregarded for over
half a century until brought to light and
verified by DR.. Fitz of Boston and DR..
McBuIney Of New York.
Acute appendicitis is characterized from
tho outset by severe abdominal pain. Co
incidently with the attack OF pain or soon
after IL begins nausea and vomiting ire
ouentiy occur. In cases where these are
produced by indigestion and Intestinal
collie the nausea Is more apt to precede the
pain than to follow it, as in appendicitis
The sudden occurrence of sharp, colieky
pains should always direct the attention
of the sufferer and tho physician 80 the
appendix vermiformis, and watchtul
care should be kept over this treacherous
organ. As soon as the diagnosis of progress
i've appendicitiS is assured tho abdominal
cavity should be opened and the appendix
removed To operate too carly may be TO
operate unnecessarily, but it is better to
do so than to operate too late anu hence
unsuccessfuliy None but surgeons OF re-
r,1+o and of assured skill should DO en-
pIoysd TO operate, for, though to remove
the apnendix is not fraught with great
danger when tho operator Is SkllIfut, 1t
may we'll become so when the surgeon en-
Moved does not understand his business
properly.
Peculiarities of tho Trouble.
Mild cases of appendicitis may recover
without surgical treatment, but quite OF
zen mild cases develop into acute aud are
Of course much more difficult to cure than
is operated upon before the trouble becal-e
intensified in its character. The disease
1,,ny pursue a rapid course in some cases
IN n fatal termination In SO hours from the
beginning of the attack. In cases which
have been successfully operated upon con-
valescence Will usually occupy about three
weeks.
Appendicitis is much moro frequent
among men than women, though the con-
trary is generally held to be the case. The
reason that women are less liable TO the
disease is probably owing TO the fact that
in them the appendix has an additional
source of blood supply in the artery OF the
apDendicular ovarian liRament and Is In
consequence better prepared to resist IN
lection than the less literally supplied ap-
pcndix of the male.
posed to be caused by the presence within
the yerniform appendix of cherry stones,
grape seeds. lemon and orange pits, date
stones fish bones, pins, etc. 80 nr1nIy was
this idea fixed in the lay and professional
minds that children were carefully Watch-
ed while eating fruit TO prevent them
from swallowing a stone or seed which
would lodge in this ''deathtrap, as the
appendix was popularity called; and pro
duce what was at that time regarded as
an almost necessarily fatal malady. Inc
came fallacy is still very prevalent among
nonmedical people, md to assign such an
origin to the disease is much more COIN
mon than to attribute it to its real causes.
No doubt the presence of such foreign sub
stances in the appendix might cause trou'
BILE there, as they would in other parts oil
the intestinal canal where they found
Judgment and could not be expelled. The
instances in which appendicitis has been
induced by such Judgments in the appen'
div have been so rare that they may be with
safety excluded IN any consideration o.
tho trouble. Another vicw-that the pair
in tho appendix is produced by an attemp
on the part of the appendix TO rld ltseI
Of focal 1uattGr-is proved TO be WRONG u.
the fact that focal matter and even colro
IiLbs have been found in the organ "hei
there was no pain or trouble with the ap
peudix at all.
A Home FOR Microbes.
The generally received opinion now
that appendicitis is caused 10y mlcro-oi
ganisms which are conveyed into the ap
pendix by fecal matter or otherwise.
These organisms may be and probably are
the same as those usually found in the in