New Ulm review. (New Ulm, Brown County, Minn.) 1892-1961, 1909-06-16
A SMALL BLIND TUBE
The Vermiform Appendix and Its
Probable Function.
PROBLEM OF APPENDICITIS.

Methods Of Fighting 1.-THE Way
the Operation Of Removal Is Per-
formed-Disease as Old as Mankind.
Appendicitis is not disease Of mod
ern times, though it's nature and meth
DDS Of treatment are the result Of
careful observation by one of our well
known modern surgeons while engaged
In postmOrtem work.
It may be safe to say that appendi-
c1t1s is as old as mankind, for in
studying very old histories wherein
are given the diagnoses of the physi-
clans we read of cases Of inflamma-
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, small blind
tube, averaging two and half inches
In length and a quarter of an inch in
diameter, attached to the coecum at
its inner and posterior part. It is
made Of very sensitive mucous mem
brane containing several glands.
The appendix is part of the digestive
tract, It's 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
ls-discharging 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
1ocalizing them and so aiding the ply
s1cian or surgeon in his work. If,
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-
n1tis, and this is generally fatal.
After the diagnosis has revealed the
disease the doctor decides whether the
case be one for medicine or external
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
dent 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 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
gases 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
sncision from two to five inches long
Is made in the skin. (Some of the best
surgeons pride themselves on the
Fmallness of their incisions in this op-
eration.) The fatty tissues are then
gut 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
Yeon to reunite them when the opera
aion shall have been completed.
The lntestines are now visible, and
She 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 it is exposed. The
word "tenderly" characterizes the
whole of this operation. as the surgeon
must be more than careful to prevent
lny rupture of the appendix, for should
this happen while he is operating the
pus would be quickly taken up by the
peritoneum and other mucous mem
branes, and the resulting complications
would make the outcome very uncer
tain.
The mesentery, large vessel adjoin-
3ng 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,
ah1s to prevent the forming Of a pouch.
The removal safely accomplished,
the intestine is replaced the edges of