Watertown leader. [volume] (Watertown, Jefferson County, Wis.) 1909-1911, 1909-07-23
A SMALL BLIND TUBE
The Vermiform Appendix and Its
Probable Function.
PROBLEM OF APPENDICITIS.


ern times, though its nature and meth
DDS of treatment are the result of
careful observation by one of our we'll
known modern surgeons while engaged
in postmortem work.
It may be safe to say that appendi-
cttis is IS old as mankind, for in
studying very old histories wherein
are given the diagnoses of the physi-
clans we read of cases of infamma-
ton of the bowels, intestinal disorders
and like ailments the symptoms of
which prove that they must have been
appendicitis.
Appendicitis is Inflammation Of the
vermiform appendix, a small blind
tube, averaging two and a half inches
in length and quarter of an inch in
diameter attached to the coecum at
its inner and posterior part. 1t is
made of a very sensitive mucous mem
brane containing several glands.
The appendix is part of the digestive
tract, its function, it is believed, being
to lubricate that part of the intestines,
though as yet there is no absolute
proof of this. Careful study of child
from whom the colon has been re-
moved until he reaches the age of
manhood has revealed no irregulari-
ties of any nature.
The causes of this disease may be
grouped under four heads-stenosis,
which means closing up; impaction,
the entrance of foreign bodies, not nee
essarily seeds; exposure and injury
In fighting this disease nature takes
three methods of disposing Of the toxic
misunderstanding them into the
peritoneal cavity, sending them into
the bowels and discharging them
through an external wound. In the
first, if the discharge be not too rapid
while the peritoneum is taking them
up, nature again makes an effort to
ward off the threatened danger by
walling the poisonous matters in, thus
localizing them and so aiding the ply
sician or surgeon in his work. IT,
| however, the discharge be sudden, as
is the case when the mass bursts, the
| whole of the peritoneum becomes in
| volved, which is called septic perito-
| nitis, and this is generally fatal.
After the diagnosis has revealed the
disease the doctor decides whether the
| treatment or for separation. In the
| latter case the greatest Of care is de-
| manded, as sometimes an immediate
| operation is necessary, while at other
| times it must be delayed, often for
| hours, until the condition Of the pa
| tient has been brought to that point at
| which the surgeon can feel it is safe to
| go ahead.
| The operation determined upon, the
| most careful arrangements to secure
perfect antisepsis are made, and the
patient is placed in a full state of an
| aesthesia.
| The operating surgeon then draws
an imaginary line from the navel to
| the anterior superior spine of the right
! hip bone, dividing that line into three
parts. Under the inner side of the
middle third the appendix in normal
cases will be found, though In rare
cases it has been found on the left side
and in extremely rare cases otherwise
| displaced.
Having satisfied himself of the exact
| spot under which it will be found, an
| incision from two to five inches long
| is made in the skin. (Some of the best
| surgeons pride themselves on the
smallness of their missions in this op-
eration) The fatty tissues are then
| cut through, the small blood vessels
| are secured, and then the muscular
walls of the abdomen are separated,
| bringing into view the peritoneum
! This is a Serious secretive lining COM
| posed of two layers. On cutting
| through this the edges Of both layers
are clamped SO as to enable the sur
geon to reunite them when the opera
| ton shall have been completed.
The intestines are now visible, and
| the affected section is very tenderly
drawn through the opening, where the
nature and extent Of the infection are
! made known. Hot towels moistened
| with salt water are kept applied to the
| Intestine while 1t Is exposed. The
word "tenderly" characterizes the
| whole of this operation, as the surgeon
must be more than careful to prevent
| any rupture of the appendix, for should
this happen while he is operating the
| pus would be quickly taken up by the
| peritoreum and other mucous mem
| branes, and the resulting complications
| would make the outcome very uncer
| tain.
The mesentery, large vessel adjoin-
| ing the appendix, is next ligated, and
| then the colon is tied off, after which
| the diseased organ is cut away. The
| stump is pushed back into the intes
| tine and the ligature is tightly drawn,
| this to prevent the forming of pouch.
The removal safely accomplished,
| the intestine is replaced, the edges Of
| the peritoneum are carefully approx
mated and the muscular walls, fatty
| tissue and skin are brought together
| by simultaneous and cutaneous su-
| lures.
| In the majority Of cases, no COM
| plications ensuing, the patient is ready
| for discharge in two weeks.-James NJ.
| Smyth, NJ. D., in New York World.
The Temple of Zeus.
All that remains Of the great temple
Of Zeus, which was 700 years in build
ing, Is to be found about $50 yards