The sun., 1898-12-27
GRIP AND APPENDICITIS
Wilmington Physicians Claim
That Philadelphia Doctors Are
Wrong in Their Surmise.
NO CASES YET DEVELOPED
They Claim That Their Patients Have
Been Afflicted With Pneumonia
and Neuralgia of the
Stomach But Moth
ing Else.

Stomach But Moth
ing Else.
There are many severe cases of grip in
Wilmington bit none of them have de-
veloped appendicitis.
Many physicians of Philadelphia for
some time past have been inclined to be.
ieve that grip epidemics are followed by
a marked increase in the number of cases
of appendicitis, but all who entertain
this view are loath to give publicity to
their ideas in the matter.
Many prominent doctors of that city
are firm in their belief that the grip is
undoubtedly the direct cause OF the
great proportion of cases of appendi-
citis.
DIR. John B. Deaver, of Philadelphia,
who has had an extensive practice in
grip and appendicitis, says:
Il have performed no less than 200
operations in cases of appendicitis,
and am. quite prepared to prove
nv contention that grip is not only a
cause of the disease, but that it is one
of the most frequent and potent causes.
l have already given expression to this
belief in several mazazine articles on
the subject. During the present epi-
demic have performed two appendicitis
operations which l do not hesitate to
say most positively had their origin in
attacks of influenza.
"The grip produces catarrhal condi-
ton of the bowels, which in very great
number of cases affects the appendix and
causes appendicitis. have made thor
ough study of the subject, and have had
exceptional facilities for observation.
That the present epidemic Of grip will
result in a vast increase in the number
of appendicitis victims is. to my mind,
absolutel v certain"
Doctor j. V. Shoemaker said yester-
day that he had often remarked that peo-
pie who had been victims of the grip
were particularly susceptible to appen-
dicitis.
"There is no question in my mind"
he said, "that an attact of grip frequently
produces conditions in the system which
render an attack of appendicitis alto
gether probable. The former disease, al
fecting, as it does, the membranes of the
various organs of the body, may easily
extend to the appendix. When it does
so, an attack of appendicitis is the
natural result"
DR.. James NJ. Anders, professor of prac-
tlce in the Medico-Chirurgical College,
expresses himself as follows:
The cases of grip during the present
epidemic are almost as numerous, though
not so severe, as those of the great cpl
demic of 1890. Still, the affection is be-
ginning to assume some very grave COM
plicatlons, notably pneum onia, peurisy,
rheumatic manifestations and, in many
cases, congestion of the kidneys. In my
text book, have shown that during the
prevalence of all epidemic of influenza,
the number OF cases Of typhoid fever are
increased to some extent, and the same
may be said of the influence of influe MA
on appendicitis, which is sometimes a
catarrhal affection. On the other hand,
the wide prevalence of influenza during
the last few years has resulted in a
marked decrease in the number of ma
I laria cases. This is, at least, indicated by
my own collective investigations,
VERY young people are less suscepti-
BILE to the disease than older persons,
and during the prevalence of epidemics
they are usually the last to be affected,
while old people, especially if they have
previously been debilitated, are frequent
sufferers.
'During the present epidemic it has
been particularly noticeable that persons
whose vitality was lowered by neuro-
pathic heredity or chronic maladies were
usually the first to be affected. The
healthy are far from being exempt. how
ever, for they now constitute large pro-
portion of influenza victims. This wear
relapses have been very common and
have proved more serious than primary
attacks. A primary attack of influenza,
20 far from assuring immunity from
subsequent attack, renders its victims
more susceptible than ever to the dis
ease.
'"There are several different clinical
varieties of influenza, all of which have
been represented in the present cpl
demic. A small percentage of cases
were of typhoid type, in which there
is high fever, with marked nervous
symptoms, such as delirium and stupor.
"As is usual, in the majoIity of cases
the predominating symptoms are those
of acute catarrh OF the respiratory tract,
with severe cough and comparatively
small amount of expectoration. There
have also been many cases of CASTRO
intestinal form, characterized by vomit-
ing, but especially by diarrhoea and
acute abdominal pain. 1 have observed
few cases Of the cardiac form, in which
there is a tendency to heart failure, with
a rapid, feeble pulse"
DR.. George H. Kobler expressed the
belief that grip epidemics are always fol-
lowed by great increase in the number
of appendicitis cases. s
'UnLil the grip epidemic of $780," he
said, appendicitis was a comparatively
disease. That year it first as
sumed serious proportions, and have
not the slightest doubt that appendicitis !.
may, in great number of cases, he found i,
to be direct result of an attack of in ',
fluenza. This is, I think, a view enter !
tanned by large proportion of medical
men who have investigated the ques.
tion."
The Wilmington physicians do not c
agree with their Philadelphia brothers q
m the matter Of grin heino tho cauoo ~ =,