The Waterbury Democrat., 1932-08-29
WHEN NEURALGIA MAKES A NOISE LIKE
 APPENDICITIS

Tn a naner read before the Buffalo Academy of Medicine Dr John B. Carnett. professor oi surgery in the medical school Of the U. ol T said
 "In patients referred to me for opera | ton for chronic appendicitis find the pain and tenderness in the lower right abdom-
 inal quadrant are due to neuralgia Tn 9o
 per cent of the patients and in the other per cent find duodena ulcer, stone In the kidney or some similar lesion l. there-
 fore have given up operations TOT chroniS ,nS
 appendicitis and cure the lower right-sided
 pains by on-operative measures directed
 toward the underlying spinal nerve iesion
 causing the neuralgia. Of the patients sent
 to me for hurry up operation TOT acute
 appendicitis find in over half or the that
 the trouble is neuralgia and do not oper-
 ate.
 pendicitis" is losing vogue It always has seemed rather a gamble in which our moderh brass surgeons have too eagerly indulged.
 A further observation by the same authoriy Is worthy of broadcastng:
 "rhe acute toxemia of tonsilitis cold or
 other infection is responsible directly TOT
 fever, pulse hurry, and leucocytosis, ana
 indirectly it's induced acute neuralgia caus-
 es lower right abdominal pain and tender
 ness with vomiting. The symptoms emu
 merated constitute the usual textbook pic
 ture of acute appendicitis and that they
 are due to acue neuralgia of the abdominal
 wall can only be determined by applying
 the tests for neuralgia In any doubtful
 case I anesthetize the right eleventh and
 twelfth intercostal and first lumbar nerves
 with novocaine injections to clminaet par
 fetal hyperesthesia and thereby am enabled
 to recognize the presence or absence oL
 any associated subparictal or true append
 ical tenderness
 We need not attempt to interpret the scan- dalous medicalcse in this. The lay reader will get the gist of it. namely, that intercostal neu- alga due to tonslitis may make noise so like appendicitis that hurry up operation may be perpetratcd If there happens to De prass surgeon at hand
 Intercostal neuralgia may closely resemble the pain of gallstone collie. Dr Carnett declares that the pain in the region of the right shoul- der blade, regarded the world over as indicative of gall bladder inflammation, IS always due to intercostal neuralgia in his experience. He de- clares that too many gall-bladders are being unnecessarily removed in the futile expectation of curing pain and tenderness which Is actually due to neuralgia in the abdominal wall
 Right here I dare suggest that physician whose education, training and practice are not limited to the tents of a single system or "school" Is better qualified to deal wiht such conditions than is the narrow little fellow who purports to practice only this or that "pathy. Beware of the chap who accepts the designa- ton of "pathist" of any kind.
 Intercostal neuralgia has led to many unne- cessary kidney operations. and to countless op- erations women who too readily believe the pain originates in tubes or ovaries
 In the hands of charlatans who run irriga- ton plants or colon filling stations a great many gullble victims of intarcoStal neuralgia are subjected to endless and vicious treat mcnt" for a colitis which does not exist, further vicious treatment. This is one of the new self -perpetuating lines of business IT. which the victims seem to like being humbugged and to resent benig enlightened.