New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1902-06-26
ABOUT AN EVEN CHANCE.

solule necessity Tor the operation Was apparent
to them
ABOUT AN EVEN CHANCE.
DR.. George G. Van Schaick. visiting surgeon
at the French Hospital. who has performed
many successful operations for appendicitis.
said:
From the latest reports received it would
seem if the King had about even chance
TO get we'll The cases of appendicitis. peri
typhtis, they usually call it abroad, which
go on to suppuration and gangrene, constitute
by far the most dangerous ones While it IS
true that untoward symptoms may manifest
themselves at any moment we usually feel that
a patient who survives few days without de-
veloping distinct unfavorable symptoms may be
considered giving good ground for a hopeful
view. 1 fancy that the majority of surgeons in
this country will feel that there was more delay
in the performance of the operation than would
commonly be permitted TO occur on this side OF
the ocean.
AT the same time appendicitis is disease
of many strange symptoms and many uncer-
talntes. and there is scarcely any doubt that
the English surgeons who represented the
highest surgical ability in England, pursued the
best possible course. Besides they probably
had to contend with the intense desire of the
King to avoid anything which might delay the
ceremonies Of his coronation. and they I'M
doubtedly were compelled to accede in great
measure 10 his wishes and operated only when
they felt that further delay might prove fatal
DIR, William NJ Polk. dean Of the medical de
partment of Cornell University. said yesterday
that il seemed to be clear that King Edward
had appendicitis, and that the attack began
when he taken i'll at Aldershot-
IF you wait at all in operation for appen-
dictis' he said, the rule is to wait four or five
days after the attack has begun in order that
the infanma ton may be walled off by the
thickening tissues which form around the alb
scess. This clearly done in the Kings case.
The rule is in appendicitis. however, TO operate
soon as you Can-the sooner the better: but
if. after four or five days, the patient continues
TO do well and the hard material-the same as
that which forms at the base of a growing boil
llp1 ThD Of nj n n
from the peritOneai cavity, the later opera ton
is. under ordinary circumstances, more dan
gerous than the earlier one The process is then
vacuatfng the apoendicuiar abscesS after it has
been well localized.
To my mind most depends in the Kings
upon the condition and action of the kid
neyS and in elderly persons some sort of kidney
trouble is very likely to he latent, and only to
axe itself felt at a critical moment. The kid
1teys are the great sewer of the body. and when
the bowels are inf1amed they taxed with re-
moving the products of tissue decay If the
kidneys are not in good shape, the tendency to
blood poisoning is increased. and this is the
greatest danger
TWO WAYS OF OPERATING.
There are two ways of operating for APP
pendicitis" said Dr. Joseph A. Blake. one of the
leading surgeons al Roosevelt Hospital One
the old fashioned-and the method proba bly,
used in the present instance-consists in the re-
mOval of the abceSs and not the appendix. The
more modern method removes both at once, pre-
venting a possible return of the trouble which
would necessitate a second operation for the
removal of the offending organ. The mere men
ton of an abdominal abscess would be almost
assurance that appendicitis was the ailment for
all such assesses result from that disease The
mortality in these cases is about l per cent in
the hands of the most skilful surgeons, while ii
varies from q TO 10 under the direction of the
average physician. When the age of the King
is considered the chance of recovery is abOu.
eighty-ve to fifteen If the disturbance is local
lied If a spreading peritonitis sets in there is
scarcely one chance in three of his recovery