Evening public ledger. [volume] (Philadelphia [Pa.]) 1914-1942, 1917-02-12

A bill in the South Dakota Legislature
that would tend to discourage operations
for appendicitis was not viewed with favor
today by surgeons Of Philadelphia. which.
With its great hospitals. is regarded as the
medical center of the country.
Such legislation, it was held. would in
crease mortality from appendicitis by curb
fhg surgery In the immediate operations
that have reduced the appendicitis death
rate. The bill proposes that surgeons be
compelled to send all removed vermiform
appendices 20 the State laboratories for ex-
animation and that II examination shows
the appendix is not diseased the surgeon
cannot collect his bill.
Dr. John e. Clark OF the University Hos
pital. and Dr. w. Wayne Babcock. of the
samariean Hospital. two of the noted sur
geons of Philadelphia, discounted the value
OF such bill.
Legislation of this nature is not rem
edy" said Doctor Babcock. ut would tend
10 check immediate operations after diug-
noss, which have been proved, in honest
hands, to be the safest and surest method
Of preventing appendicitis"
Doctor Babcock's opinion is backed up not
only by his reputation as n surgeon, but
also by the practical application of his the
ory to himself. More than n month ago Doc
tor Babcock, at his own request was OPP
Grated upon for appendicitis after he had
diagnosed MS own case.
Doctor Clark's opinion Of the value Of the
immediate operation after diagnosis was
summed up by him in exactly twenty-five
words. He said:
ut is better to take out a normal appen-
dix occasionally than to make a practice Of
waiting until the patient becomes worse or
perhaps dies, That Is my opinion in a nut
she'll"
The prime object Of immediate operation,
The surgeons said, Is TO remove the vermi-
form appendix before II becomes markedly
diseased and before the disastrous compli-
cations set in. That these operations are
formed in the first stage Of appendicitis are
safe Is shown by the fact that about one
tenth of one per cent of the patients--or
one in a thousand-dic from the effects of
operation in the simple cases. they said.
/ Two per cent, it was estimated, Is the NOR
tality in all classes of cases in good hands
, including the worst cases developing alb
scess, gangrene, perforation or other compli-
cations.
Virtually every death from appendicitis
means that some one has been derelict in
delaying the operation" said Doctor Bah
cock. Heavy appendicitis mortality comes
from delayed operations"
There Is a growing tendency. Doctor Bah
COCK SAID, on the part of the American Col
lege OF Medicine TO supervise operations.
This organization. which has between 1000
and 5000 physicians as members, admits no
candidate for membership unless he pre-
sents proof that he does not operate indis-
crimnately for practice or for mercenary
reasons. The time is coming, he predicted,
when the college will cooperate with hospi-
tals IN closer supervision of operations, so
mat surgery shall be placed on a still
higher plane than the high one which it now
occupies.
Doctor 'Babcock referred to several series
oi hgures that have been tabulated all
showing that delay in operation is danger
GUS According to these tables, mortality
from appendicitis rises from an insignificant
percentage when operation takes place the
. hrst DAY to rather substantial figures when
operation is postponed Nearly n fourth
vi the patients who undergo operations
upon the fourth day and after die.
"a series Of operations observed during
isVS-l2 and reported to the Swiss Surgi-
ssI society show the following mortality
cases: