The Columbian. [volume] (Bloomsburg, Pa.) 1866-1910, 1900-01-25
APPENDICITIS AND PERITONITIS.

The diseases which head this article
seem to be growing alarmingly pre-
vaIent. Several recent cases in this
vicinity have aroused interest, and
many questions have been asked as to
the nature of these diseases. The
names are commonly mispronounced,
as though the suffix were ehS. The
best authorities give the the long
sound, as though it were spelled
eyeHS.
For the information of those who
care to know, we quote the following
from the New National Encyclopedia.
"Appendictis is inflammation OF
the vermlform appendix ofthe cecum,
a worm.llke, blind sac in the lower
right side of the abdomen. The causes
are various, exposure 10 cold or damp
ness, or some indscretion in diet,
being the most usual. In a large pro-
portion OF cases, foreign substances
are an active factor in the production
of the disease when a catarrhal condi-
ton Of the mucous membrane already
exists. In the absence of this condi-
tion, foreign bodies may remain and
cause little or no disturbance but
should the membrane become in.
famed, they add to the irritation by
occIudlng the lumen of the appendix,
thus iavorlng liberation of the walls,
pertoratlon, and even gangrene of the
whole organ. Catarrhal inhammations
of the appendix are common and fire.
quently chronic, but have not hereto
fore been recognized as appendicitis
Several forms of this disease are now
recognized, as acute, chronic, and
recurrent; also rheumatic appendicitis,
which is observed In cases presenting
rheumatic dlathesls. Acute, severe
attacks occur when the bacillus Gem.
nuns s0H Is present in vlrulent form,
and if this condition be associated
with f9cal concreton or other for
elgn body causing pressure, there is
Imminent danger of necrosis, perfora-
ton, and death. The symptoms of
appendicitis are intense, cramp-ll like
pans, which may not at first be located
in the right lilac fossa nausea, if not
vomiting; rigidity OF the abdominal
walls, especially of the right side and
before the pain locaizes itself; constl-
patton generally, but diarrhea occas-
lonally; intense thirst; disposition to
flex the thighs upon the abdomen
and extreme tenderness at the seat of
the disease. The infamed appendix
may generally be felt by deep palpa-
ton. Extreme local tenderness at this
spot is valuable diagnostlc sign dis
tlngulshing appendicitis from general
perltonltis. In moderately severe cases
pulse.rate and temperature are not
seriously affected, but sudden fall in
temperature often indicates perfora-
tlon and is therefore a suspicious
symptom. Medical treatment frequent
ly affords relief, but many practition-
ers recommend excision of the appen-
dix as the only radical cure, and also
as preventive. This operation is
now performed with great success, the
rate of mortality being only two or
three per cent, exclusive of cases in
which surgical interference is made
during an acute attack, when the
mortality is much larger-perhaps IS
to 20 per cent. Complete natural
obliteration of the lumen of the ap
pendix has been observed, resulting
in spontaneous and permanent cure.
The vermiform appendix is slender
blind sac opening from the intestlnes,
from three to SIX inches long, and with
a calibre about that of a tobacco-pipe
stem. 1t opens into the cecum, on
its inner and posterior wall. 1t is
found in man, the orang, certain
lemurs, and the wombat, being large
and functional in some of the lower
ami mails. Focal matter from the
bowels may enter this tube and cause
inflammation. This is usually allayed
by treatment, but If an abscess forms
there is serious danger of its producing
: an opening in the wall of the appen
dix, admitting fecal matter to the
abdominal cavity, and causing fata
peritonitis. In such case surglca
Y operation becomes necessary, the
aperture being closed or the appen
dix excsed.
t Peritonitis is inflammation of thu
4 peritoneum, including metro,perlto
4 nitis suDDuratlye peritonltis. tubercu