The Washington times., 1922-07-16
By DIR. w. HUTCEIINSON---
Eminent Physician Whose Health Articles Are Widely Read)
Appendicitis Once Deadly, Conquered by Knie-Modem Surgical
Sk Has Made Operation One of Safest of Major 0ass-TphoM
Fever Close Second i'm Fatality Of Attack ON Peroneumen
Disease Only Recently Understood. ---.----


--nor in fact had any one else un-
til some thirty-five years ago.
About this time two able Amer
lean surgeons. Doctors Sands and
Fitz, began to see the light" and
its true nature and brilliant cure
by operation were. worked out.
Here was q wholly new solution
of one Of the most battling and
deadly forms of Essential inflam-
nation Of the bowels" or lido
pathic peritonitis," as the vague
old terms ran.
BECAME FASHIONABLE.
Popular opinion was entranced
by the possibilities. and almost
overnight appendicitis became pos
itiveiy fashionable.
The whole cause Of an this
furore is small. unobtrusive piece
Of the intestine. about the size and
shape Of the little finger which Juts
out peninsula fashion from the
junction Of the large and small In
testine.
It's only apparent use 10 ~ .
proof that forgetfulness 10 not con-
fined to humans but that even
Dame Nature like Providence, can
be absentminded at times. and
leave about scrae-ends that should
have been clipped off long ago.
Originally the appendix was a
secondary or reserve stomach. as
sisting in the digestinE Of grass
and, woody fibre; now It has
shrivelled UP into this tiny frag-
ment-but it still hangs on. and
when It goes on rampage it's lit
tle-but how It can make trouble!
Just what starts It off on its
career OF crime 10 quite uncertain.
Sometime q severe strain or an
injury. like q blow or kick In the
stomach. or material from the main
intestine gets Jammed down into
this little fnger-stall, and Ii un-
able to get out again.
But moro often II In due to some
direct septic infection like an at
tack Of the FLU" or tonsillitis,
settling in this cramped and twist
ed little point Of least resistance.
TONsns TO BLAME.
This latter affliction Is not chos-
en- as an example by mere chance.
for the tonsils are now believed to
be q regular Robbers Roost." from
which bandit baSilli sally forth on
their 'nefArious.. errands through
the blood OF. their uhsuspecting
host, and some types Of these seem
to have an especial affection for
the appendix.
There seems to be little basis for
the idea that diet has any special
connection with appendicitis. or
that the swallowing Of fruit pits or
seeds will bring on an attack.
Appendicitis, It 10 true, does not
generally appear until after a
severe attack Of indigestion; but 1t
Is probably the preliminary ''tun-
ing up" Of the appendix that
causes the indigestion" and not
the reverse.
Moreover, an appendix may
gradually collect solid material out
of the intestine. and build up lit
tie calculi or stones inside itself.
which have a remarkable super
ficial resemblance to date pits or
cherry stones. but which are. Of
course, nothing Of the sort.
Also there is nothing to prove
that these internal stones will pro-
woke an attack. in fact. they are
often found in perfectly healthy
appendices during routine post
mortem examinations.
SYMPTOMS UNNnSTAKABLE.
Once the attack has begun there
can be no question that something
has gone seriously wrong. Intense
pain, often worst In the lower
right hand corner OF the abdomen
but at times completely diffused
all over It. . slight but unmis-
taxable fever, and q quickened
pulse-these are the danger sig
mails.
II an operation is performed at
once, there is every possibility that
the appendix can be taken out
before It bursts and floods the
peritoneum with septic matter,
thus setting up peritonitis. This
latter Is the cause Of death In most
fatal cases.
On the other hand the appendix
may turn itself into a regular
sieve from the very beginning Of
the attack, and leak the septic mat
ter all over the peritoneum so that
a widespread joint attack Of ap-
pendicitis and peritonitis flares
out as suddenly as an exploding
mine.
To give the peritoneum its due,
II In M onward or weaklinR. giving