The propriety of the removal of the appendix vermiformis during the intervals of recurrent attacks of appendicitis / by Frederic S. Dennis.

  • Dennis, Frederic S. (Frederic Shepard), 1850-1934.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: The propriety of the removal of the appendix vermiformis during the intervals of recurrent attacks of appendicitis / by Frederic S. Dennis. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The second way in which an appendicitis may terminate is by the formation of pus and the evacu- tion of the abscess, either spontaneously or by surgical interference. In regard to the chances of recovery offered by an early operation, it has been shown that there are fifty per cent, more recoveries following operations before the eighth day of the disease than after the eighth day, and that the mortality is only eight and one-half per cent, in those cases operated upon before the eighth day. If now the operation of incision is performed during the second or third day of the disease in these relapsing cases, the rate of mortality is lessened to such a degree (as shown by a study of Weir’s, Bull’s, and McBurney’s cases) that the mortality is comparatively insignificant. If now out of the eleven per cent, of cases of re- lapsing appendicitis there are deducted first those cases which terminate by resolution, and second, those cases which recover by early incision, it is obvious that only a small part of the eleven per cent, of cases are exposed to the remaining source of danger, viz., perforation and general peritonitis. The whole question of removal of the appendix, therefore, practically has reference only to those cases in which a general peritonitis, the result of a perforation, is likely to arise. It is under these cir- cumstances that death follows, and the excision of the appendix is the only measure that will remove this cause of almost certain death. The line of argument thus pursued brings us face to face with the clinical fact that removal of the appendix is to be considered only as a means to protect a patient in the future from death by a peritonitis the result