Western news and the Libby times. [volume] (Libby, Mont.) 1920-1933, 1929-01-10


ten serious trouble comes when no
improper eating is INDUCED in. 1t is
not wise to conclude that pain in the
abdomen is due to something that
has been eaten for deeper trouble may
be developing unawares.
8. Also it may be securely assert
ed that once appendicitis, always APP
pendicitis. Only about per cent of
individuals escape further trouble if
definite attack has occurred. Even
the mild and often unnoticed spells
nre apt to increase in severity and
go on either to rupture and gangrene
or to chronic state. with painful ad-
hesions and general failure in health.
I shall now answer in order the
questions asked by DR.. Register.
What are the symptoms Of appendi-
citis in its incipient and acute forms7
The symptoms of acute appended
It's in order of their occurrence and
Importance are: IL pain, ca nausea
and vomiting, (3) tenderness. al rig
id muscles, (5) slight fever, and (6)
a high percentage of white cells IN
the blood.
These are called the cardinal symp-
toms, but they need not all be pres
ent to make a diagnosis; in fact, if
we wait for the complete signs to
develop, the case may be SO far adj
vanced as to result fatally. With three
of these symptoms existent dag
nosis should be made; these are ~
pain, (2) tenderness, and CD rigid
muscles.
First and foremost is pain. It be-
gins, not over the appendix (Which
is situated in the lower right sidel,
but in the pit Of the stomach, around
the navel or even in the left side
of the abdomen. The sufferer thinks
he has "the collie" After a time,
varying from 8 to hours, the pain
gradually works down to the right
side, where it locates The tender
ness to pressure appears at the base
of the appendix and the muscles over
it begin to get rigid. In practically
all cases there is nausea; in many
vomiting may be absent. The fever
comes later and, as a rule, never
goes very high. 1t is no indication o.
| the severity of the case. When tht
| blood is examined the white cells ar,
| found increased in number, showing
THE patients power Of resistance ant
| the virulence of the disease. The Sc
quence of the symptoms is signlfl
cant. Pain, which ,invaribly come
first, and nausea and vomiting, whic'
follow promptly, when they do oc
cur, are the symptoms which the pa
tent himself feels in the very begin
ming Of the attack. The other symp
toms are brought out by the physic
ian when he examines the patient.
What symptoms are sufficient
serious to indicate the necessity 70
prompt Operation in order to avoi
fatal consequences?
One should not wait for symptom
to become sufficiently serious to ind
cate the necessity for prompt opel
alton. The only essential is sati:
factory diagnosis, reasonable a:
surance that appendicitis is presen
and then a prompt operation for il
removal. If every patient were opel
ated upon in the early stage, say tn
first IL or "a hours, there would
practically no deaths from the diseas
It is delay that kills, not operation
Those patients that die have waite
until the appendix has burst into II
belly, either because gangrene hi
set in or a perforation has take
place. Previous attacks, howeys
slight, are constantly responsible Il
these sudden disasters.
The most deceiving firing is tina
when rupture or gangrene has o
CURED there is sudden cessation I
pain and the patient and his fami
Z imagine he is better. Instead of tn
he is worse, and, if not operated 0
he will die. Time after time patien
in such condition will insist that the
"feel all right" when the tenderne
is more marked, the pulse rate
increased, the blood-count is goil
higher and peritonitis is starting.
long as the pain continues Witho
stopping, there is hope of taking o
the appendix whole, and thereto
avoilYng drain When THE pa
stops suddenly, peril is impending al
complications may be expected.
These catastrophes, Of course, d
mand immediate operation; but he