Bryan daily eagle and pilot. [volume] (Bryan, Tex.) 1909-1918, 1909-09-10
4 SMALL BLIND TUBE



DDS Of treatment are the result OF
careful observation by one of our well
known modern surgeons while engaged
IN postmortem work.
II may be safe to say that append.
eitis is rs 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, q small blind
tube. averaging two and half inches
In length and quarter q an Inch In
diameter. attached to the coecum at
its inner and posterIor part. II h
made Of very sensitive mucous men,
brane containing several glands.
The appendix IL part Of the digestive
tract. its function. II h believed. being
to Intricate that part Of the intestinca.
though a. yet there In 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 irreguIari-
ties OF any nature.
The causes OF this disease may be
grouped under four heads -stenosis
which means closing mp: impaction.
the entrance OF foreign bodies. not nee
essarily seeds: exposure and injury.
In fighting this disease nature tsker
three methods Of dIsposlng OF the toxic
materials -dIschargipg them into the
pcritoncai cavity. sending them Into
the bowels and dIscharging them
through m external wound. In the
6rst. II the discharge be not too rapid
while the peritoneum h taking them
up. nature again makes an effort 10
ward on the threatened danger by
wallinr the poisonous matters In. thus
IocalIxIng them and 20 aiding the ply
sicIan or surgeon In his work. II.
however. the discharge be sudden. nv
Il the case when the mass bursts, tn
whole Of the pcrifopcum becomes In
volvcd. 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-
mandsd. as sometimes an immediate
operation Is necessary. while at othe-
times Il must be delayed. often for
hourx. until the condition Of the pa
tIent has been brought to that point at
which the surgeon can feel II n safe ~
20 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 e.
the anterior superior spine OF the righ'
hip bone. dividing that line into three
parts. Under the inner side OF the
middle third the appendix In normal
cases VIII found. though In rare
cases II has been found on the left side
and In extremely rare cases otherwise
displaced
Having satisfied himself OF the exact
spot under which II win be found. an
incision from two TO Eve inches long
Ia made In the skin. tSome OF the beat
surgeons pride themselves on tho
smallness OF their incisions In this op
eratIon.s The fatty tissues are then
cut through. the small blood vessels
are secured. and then the muscula-
walls Of the abdomen are separated.
bringing into view the pcritoncum
This Is a Serious secretivc 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. ana
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 arc kept applied to the
Intestine while II Ii exposed The
word ''tenderly" characterixeS 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 h operating the
pus would be quickly taken up by the
peritoneum and other mucous mem
branes. ard the resulting complications
would make the outcome very uncer.
tain.
The mescptcry. large vessel adjoin.
ing the appendix. Is next ligafed. and
then the colon h tied on. after which
the diseased organ Il cut away. The
stump Is pushed back into the intes
tine ana the llgature IL 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 aud skin are brought togcthe
by rbcutaneous and cufaneous su
lures.
In the majority OF cases. no com
plications ensuing. the patient Is ready