Bryan daily eagle and pilot. [volume] (Bryan, Tex.) 1909-1918, 1909-06-29
A SMALL BLIND TUBE
The vermiform Appendix and Its
Probable Function.
PROBLEM OF APPENDICITIS.
The Causes Of the Disease and the
Methods Of Fighting 1.-THE Way
the Operation Of Removal 10 Per.
forned-Disesse ~ Old - Mankind

ods OF treatment are the result o
careful observation by one OF our wei
known modern surgeons while engaged
In postmoriem work.
II may he safe TO say that appendi
citis Is ms old as mankind. for IN
studying very old histories wherein
are given the diagnoses OF tbs physi
clans we read OF cases OF infamma.
tion 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 half inches
In length and n quarter OF an inch In
diameter. attached 10 the coecum az
its inner and posierior part. II Is
made Of n very sensitive mucous mem.
brane containing several glands.
/. The appendix is part OF the digestive
tract, its function. II is believed. being
20 lubricate that part Of the intestines.
though as vet there Is no absolute
| proof OF this Careful study Of n child
from whom the colon has been re-
moved until he reaches the age ~
manhood has revealed no Irregular
! ties OF any nature.
The causes ~ this disease may be
grouped under four Embellishments.
which means closing up; impaction.
the entrance ~ foreign bodies. not nee.
essarlly seeds: exposure and injury.
! In fighting this disease nature takes
three methods OF disposing OF the toxic
erials-dlscharcing them into the
perltoneal cavity. sending them into
the bowels and dIscharging them
through an external wound. In the
first. II the discharge be not too rapid
while the peritonehm Is taking them
up. nature again makes an effort 20
ward OF the threatened danger by
wallIng the poisonous matters in, thus
localizing them and so aiding the ply
stefan or surgeon In his work. II.
however. the discharge be sudden. as
Is the case when the mass bursts. tn
whole OF the pcritoneum becomes In
volved. which Is called septic peritc-
nitis. 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-
handed. as sometimes an immediate
operation Is necessary. while nt othe-
times II must he delayed. often for
hours, until the condition Of the pa
tient has becn brought 10 that poln, q.
which the surgeon can feel IL is safe To-
go ahead.
The operation determined upon. the
most careful arrangements TO secure
perfect antisepsls are made. and the
patient Is placed In full state Of an
aesthesia.
The operating surgeon then draws
an imaginary line from the navel &
the anterior superior spine Of the rigl
hip bone. dividing that line into tire,
parts. Under the inner side of the
middle third the appendix In norma.
cases VIII found. though In RAJ J.,
cases II has been found on the left side
aud In extremely rare cases otherwise
displaced
Having satisfied himself OF the exact
spot under which Il will be found. an
incision from two TO FIVE inches long
Is made In the skin. CSome OF the best
surgeons pride themselves on tho
smallness OF their incisions In this or
orationJ The fatty tissues are then
cut through. the small blood vessels
are secured. aud then the muscula'
walls of the abdomen are separated.
bringing into view the perlioneum
This is n Serious secretive lining com
posed Of two layers on cutting
through this the edges OF both layers
are clamped so rs TO enable the sur
geon 10 reunite them when the opera
tion shall have been completed.
The intcstlnes are now visible. and |
the affected section Is very tenderly
drawn through the opening. where the /
nature and extent 81 the Infection are |
made known Hot towels molstcned I
with salt water are kept applied 20 the |
Intestine while II Is exposed. The |
word "tendcrly" characterlzcs the /
whole Of this operation. as the surgeon |
must be more than careful 10 prevent |
any rupture Of the appendix for should /
This happen while he Il operating che /
pus would be quickly taken up by the
pcritoncum and other mucous mem,
branes. and the resulting complications |
would make the outcome very uncer
tain. TessFeslF-ssi ~ .s..-,.s --- I
The meseptery, a large vessel adjoin-
Ing the appendix. Is next llgated. and
then the colon Is tied of. after which
the diseased organ r. cut away. The |
stump Is pushed back Into the intes'
tine and the ligature Is tightly drawn,
this 10 prevent the forming % n 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 togethe I
by subcutaneous and cutnneous su-
lures.
In the majority OF cases. no com |
plicaiions ensuing. the patient Ia ready
for discharge 10 two weeks.-James NJ. 2
smyth. NJ. D.. in New YORK World.