The sun. [volume] (New York [N.Y.]) 1833-1916, 1902-02-09
LAST VIEWS ON APPENDICITIS.
LATEST CONCLUSIONS or PHYsI-
CLANS ON THE SUBJECT.
n Ala OF the surgeon imperative I'm
Certain Cases Most Approved Treat
ment-Dansers Of tho Operation
The Period of Cony aieseence.

the oma and bowels, Ia an advocate,
and a strong one, OF the treatment OF all
cases of appendicitis by the oil remedy.
as he calls 1t. He has succeeded In getting
his treatment OF the now fashionable and
dreaded disease much talked Of and written
about, but no very definite explanation
OF the treatment has como to the laity In
localities so far West as New York.
Generally speaking, the Squier remedy
Ia a medical treatment rather than treat
ment by surgical operation. DR.. Squier
Is evidently opposed to all attempts TO
cure appendicitis by the removal OF the
appendix. In q recent publication he 10
quoted as saying:
Fully 80 per cent. OF those affected by
appendicitis will get well without an opera
ton. while the other 20 per cent. will die
whether IN operation Is performed or not.
Therefore, II will make no material differ
ence whether or not an operation Is per-
formed, so far as recovery In concerned
Ever since the presence In the human
body OF tho appendix was discovered and
IL became known that. In order TO be in
good form, old-fashioned Inflammation OF
the bowels ought to be called appendicitis.
physicians have been trying to discover a
way Of curing acute cases Of appendicitis
by medical treatment. This end has been
sought, probably, for the reason that most
persons ave come TO believe that they are
taking their lives In their hands when they
submit 10 an operation for the removal OF
the appendix.
AZ q matter Of fact, the operation m
itself is most simple and there Is no more
reason why a fatal result should follow
the removal OF the appendix than II should
from the amputation OF a part or the whole
of A finger. The danger from the operation
lies, not In the operation itself, but III the
general condition Of the patient and the
particular condition of the appendix. II
should also be stated that the highest au-
thorities on the subject agree that few "
any. cases Of acute appendicitis can be
cured by medication.
The latest and most approved treat
ment 81 the disease, a treatment approved
by such surgeons ms DR.. Bull, Dr.. John
Il Walker, Or. McBurney and DIR. Weir,
and such physicians as Or. Janeway, Dr.
Dclafeld and Or. Partridge, includes both
medication and surgery. Before explain
ing the combination treatment II should
be stated that there is a very material diff
ference between appendicitis and appen-
dicular collie.
Appendicular collie Is an Inflammation
IN the appendix, which causes a swelling
that partly closes the sac near its mouth.
Appendicitis is produced by an infiamma-
ton 80 acute az entirely TO close the mouth
Of tho appendix Cases Of perpendicular
collie may be cured by medical treatment,
and the treatment il as follows:
When n pain is felt in the region Of the
appendix. the patient should immediately
go 10 bed. apply hot or cold applications
10 the region and take triturated tablets
Of mercury Of such strength as a physician
NAV prescribe and at the intervals and for
the length Of time lie may prescribe,
When the designated number OF tablets
have been taken, the treatment should
be followed up 10y the taking OF some such
purgative NJ citrate OF nhgnesia. The
hot or cold applications are used for the
purpose Of reducing the Inflammation
and the mercury and purgative are for
the purpose of clearing the bowels.
II, however, the disease does not yield
to this treatment. that is, If the infian-
nation Is not reduced and the pain allayod,
then. according To tie highest authori-
ties. il j. time TO send for a surgeon. The
length Of time that must elapse before the
surgeon Is sent for, if az all. must be de-
termined bv the physician.
IL should be added that the best known
! surgeons advise the calling Of a physician
in every case Of inflammation OF the APP
pendiX. slight or acute, before a surgeon
is summoned. In speaking on the general
subject Of APPENDICITIS not long ago, Or.
John u. Walker said
"If were taken with appendicular collie
or acute appendicitis, the first thing I'd
do would be 10 send for DIR. Janeway or
Or. Dclafeli, or some other equally good
physician, and put myself in his charge;
When h. said 10 call in a surgeon. I'd call
him aud not before. Up TO the time OF
oparatiny, appcudicular collie or appen-
diriti1 should be looked after by a physi-
clan, but a worry competent one.
II often happens that acute cases OF
a~ppendicular collie may he cured not once
but several times, by medication. There
+ one case, known to some Of the surgeons,
ia which the patient had regular attacks
Of apDendiCular collie about three times a
wear for four or five years, and each attack
Welded 10 medical treatment, except the
last. At the last attack the appendix had
to be removed.
The difficulties attending the operation
for the removal of the appendix result
almost entirely from the delay in calling
IN the surgeon. The answer to the ques-
ton, when 70 operate for appendicitis, has
involved the loss and the saving OF many
lives. In speaking Of this the other day
one Of the highest authorities In this country
on the subject said: -.
IF the physician or the surgeon could
tell the exact time al which The patient
should submit TO an operation for arpen-
/ diritis, the deaths resulting from the opera
ton would bc so few AZ 70 be counted among
the rare accidents of surgery. The opera
ton itself Is particularly simple that Is,
il il as simple as any abdominal surgery.
"The danger of a fatal result from an
/ O1nffNlIll lf . AA NV AplAlANNhA W AAAt hIl'AA-
dix and not in the operation per sc. Let
In" explain.
If The surgeon finds, when he gets down
10 the seat Of the trouble that the organ is
free from pus and not particularly gam
grcnous tho organ may be removed, the
iucision scwcd mp and in about three weeks
the paticut will be a. well rs he ever was.
IF, on the other hand. II il found that the
| appendix is entirely gangrenous or that II
has been puncturNd and the nus has flowed
out into the intcstiues, then there is trouble.
Then the operation is attended by prac-
ticallv tho only formidable danger con-
/ uectcd with the operation. the danger from
blood poisoning. II we have sepsis TO
contend with, thon the chances of ecovery
are not 80 good as they might be-"
This Is rather a conservative way OF
srcakiug Of the dangers to he met in operat-
ing when the appendix il punctured. The
surgeon might have spoken more alarm
inrly Of those dangers and yet not magnifed
them n great deal.
II Is not the purpose OF this article to
prescribe n treatment for appendicitis or
10 magnify or minimize the dangers re-
suit ing from an operation. The fact IL,
and IL l. only statements OF fact that IL
is desired 20 give, that, il the appendix is in
a fairly healthy condition, no one need