Los Angeles herald., 1905-03-12
SURGEONS DEBATE
APPENDIX CASES
SIR FREDERICK TREvES HAS
REMARKABLE RECORD
Has Operated on a Thousand Cases
and Never Lost q Patient-Treat-
ment Adopted In Recent
Years

LONDON, March 11.-If, ss was nip
PANTY remarked recently in the edi-
toriai columns Of one London paper.
the removal of the appendix is an es-
sential qualification FOR entry into
smart society," the meeting the other
night Of the Royal Medical and Chi
rurgical society should have been the
occasion OF very smart gathering,
for it's interest centered, so to speak,
round the appendix.
Those present, numbering more than
two hundred surgeons and physicians,
had two hours Of appendix, and in the
course OF Sir Frederick Treves lucid
address, which opened the discussion,
even layman had ample occasion to
improve his perfunctory acquaintance
with 1t.
How thoroughly modern the subject
is was made manifest by the casual
Introductory remark by Sir Frederick
Treves. He mentioned that when in
1887, before the very society which now
had mustered in full force to discuss
the complex problems at times pre-
sented by operations, he had first
mooted the advisability Of the removal
of the appendix in cases of recurrent
attacks, his suggestion was received at
the time with polite scepticism, not
unmixed with derision; but since then
a deal of water had flowed under the
bridges. Sir Frederick had himself
in his private practice operated on
more than a thousand cases without
a single death to mar the success Ct
his record. A great London hospital
records within a period of four years
total of exactly one thousand cases
| of operations for appendicitis, most of
them successful except when the dis
ease had brought about general peri
| tonitis before operative treatment was
possible, the mortality being little over
per cent. Similar favorable results
were shown by the statistics furnished
by several of the larger general hos-
pitals.
! In the Dark Ages
In view of these astonishing figures.
it occurred TO the lay mind to inquire
|
of those who, seeing that the appendix
was not modern innovation. in the
internal mechanism of the human race,
had suffered from appendicitis in the
dark ages. before the introduction of
the Treves operation. He was told in
a hurried aside that they were reported
to be suffering from collie and other
| al
that In very many of the cases the pa
tient, whose life would now be saved.
died Of unrecognized appendicitis.
The greater part of Sir Frederick
Treves' address was devoted to the con-
sideration Of the causes of relapse after
the removal of the offending appendix,
as shown by the recurrence of at
tacks. The majority of these are of
too technical a nature to admit of APP
probation by laymen, but one or two
of them are of more curious interest.
The recurrence of pain is at times
due to incompleteness of the operation
when the whole appendix has not been
entirely removed.
| Often, again, the pain is due to a
l
| stomach.
Cases of Purely Neurotic Pain
Even more extraordinary to the lay
mind are cases which have occurred
where the pain is altogether neurotic,
a question of nerves pure and simple.
Again, mistakes in diagnosis do occur,
and before now a man has been de-
prived of the unoffending appendix
only to find that the trouble had it's
seat in quite a different part of his
machinery.
Sir Frederick did not against all tra-
dition quote the familiar story of the
man who to guard against contin-
| gencies in the event of the sudden loss
of consciousness wore tattooed on his
thumbs, do not operate; have had
appendix removed three times" but
he told no less remarkable story of a
| patient who had come to him with a
relapse after having undergone an OPP
GRAFTON for removal Of the appendix.
In investigating the matter Sir Fred
erick was able to remove it for him a
second time. On the first occasion pre-
sumably the surgeon had overlooked
it.
Much more formidable than opera
tions during the quiescent period after
an attack are those necessltated by
local or general peritonitis during the
attack known as cases of "fulminat-
ing appendicitis" when every hour is
OF vital Importance.
In such cases this always is a. ques-
tion OF touch and go. but even in these
cases London Is able to record OF late
marked increase In the number OF
cases successfully treated.
Altogether from the layman's point OF
view the discussions, which evoked TOO
many speakers and too widespread an
interest to be dismissed In single
session, and will therefore be continued
next week, were decidedly reassuring
If he is fated to be deprived OF his
| .,.,.a,,atr which In any case Is of no