The watchman and southron. [volume] (Sumter, S.C.) 1881-1930, 1902-07-16
The Case of King Edward.

The Case of King Edward.
The illness of King Edward is dis
cussed by some Of the most eminent
physicians in America, in series OF
signeda articles, printed in the cur
rent number of the New York Medical
Journal, and their views are of very
general as we'll as professional inter
est, because of the fact noted by one
of them that the subject is of greater
consequence than the Boer war or
the war in the Philippines, on the
score Of death rate at least, because
the annual death rate from appendic-
tits improperly managed is greater
than the death rate from war;" and
because of the further fact, noted by
another, that the Kings case is an
object lesson to the world'' in that
disease. s-...
We note some Of the points made by
the writer's which are most instructive
for the general reader.
In it's introduction to the symposium
the Medical Journal first gives a sum-
mary of the previously published opin-
ions on appendicitis of Sir Frederick
Treves, who performed the operation
on the King, in one of which he prac-
tically Identifies peritypnilitis with ap-
pendicitis. In.another be quotes DR..
Elnhorn, of New York, who gives the
origin of perityphilitis as appendicu-
lar In 81 per cent Of Is, 600 post-mor-
TENS. I" .Perityphlitis,' he says,
/" represents the very colnmonest form
of peritonitis, and the remarkable fre-
ouency of Inflammation in. this posi-
ton is due to the fact that the appen-
dix is one of the weakest points in
the abdomen. He also mentions
typhoid fever as one Of the causes OF
the disease, which suggests to the
Journal the possibility that the attack
of typhoid from which tae King near
ly lost his life in the sixties was COM
plicated by appendiciaI disease, then
unrecognized. "The main feature, -
he says, Gin this treatment" during
an acute attack consists OF the ur-
gent advice that a free incision
should be made down through the in
famed area as soon as there is evi-
dence that suppuration has taken
place.
It is to be noted that The Kings
attack, which began on June l6 with
a chill, nausea, severe pain and alb
dominal trouble, subsiaed later: and
that the symptoms became SO acute
again on June 24 that an instant ope-
ration was performed.
In discussing his case DR.. Alexan
der H. Ferguson, of Chicago, re.
marks: eff he were beggar, instead
of a King, I judge that an early ope-
ration, within twenty-four hours OF
the attack, as is our rule in Chicago,
would probably have been done and
the disease have been thereby proba-
bly robbed of its dangers. - The
Kings case, he goes on to say, is
an object lesson to the world in ap-
pendicitis. At the Deginnlng
of the attack, and for few days
thereafter, the symptoms and signs
were not alarming, and herein lies
the deception in appendicitis. The
symptoms improve, and then light up
again. as they did with the King.
do not think it wise to tempo
rize: once a diagnosis is made, an
operation is tie only rational and safe
treatment. In the gravest
cases the mortality is higher, but in
early operations, that is, within twen-
ty-four hours, very few die. In my
experience the mortality is less than l
per cent.
DR.. John B. Murphy says:
elf the diagnosis of appendicitis
had been made early it is probable the
operation would have been performed,
Immediately, as the consensus Of opin-
ion of the American medical and sur
gical pofession is tat the immediate
operation, i. e., operation within the
twenty-four hours after the onset Of
symptoms, give the best results and
subjects the patient to the least risk.
There is unanimity, of opinion in
the profession that no one, no matter
how familiar with the disease, is able
to predict from the early symptoms
what will be the subsequent course OF
the disease. It is therefore, incum-
bent upon the profession to operate
early to avoid the probability OF later
and most dangerous pathologic con-
ditions Expectant or medical treat
ment is uncertain, inefficient and
hazardous, and thousands of lives
have been sacrificed by this method OF
treatment In Chicago alone in the
past three years there have been seven
hundred and ffty-two deaths from ap.
pendicitis. What colossal crime. !.
What an indulgent and forbearing
public to tolerate such results from
the medical profession :"
DIR. Robert F. Weir, of New York,
discusses the case briefly with refer
ence to special complication
(diabetes) in the Kings case, but
notes that where the operation is done,
in general cases, within thirty-slS
hours after the inception Of the disease
the mortality is under 3 per cent:
after that period to the fifth day is
from to Is per cent. and after the
fifth day. when the disease often limits
itself to a circumscrihed abscess,
again markedly diminisbes.
DIR. Robert Able, of New York, re-
marks that "accumulating experience
shows that not once in hundreds of
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