The vermiform appendix and its diseases / by Howard A. Kelly and E. Hurdon.

Date:
1905
Catalogue details

Licence: In copyright

Credit: The vermiform appendix and its diseases / by Howard A. Kelly and E. Hurdon. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    the year 1886 with great rapidity, and has now assumed such proportions that it is no longer possible for a surgeon not devoting himself to its special study to keep abreast of it. In the present historical review my aim has been to emphasize the notable contributions which have marked periods of progress, rather than to offer an imposing array of names. I present here, therefore, a sifted literature, from which I trust my readers will agree that I have selected those names most worthy of being retained in the medical hall of fame—names of men possessing discrimination and keen insight; men who have reasoned on the problems presented at the bedside and at the autopsy table; men who have even, in some instances, forestalled the slow march of history by brilliant prophecy. The first recorded case of disease of the appendix is the classical one of Mestivier, reported in 1759.* A man of fort}'-five sought relief for a tumor in the umbilical region on the right side; fluctuation could be detected, and about a pint of pus was evacuated by an incision; the wound healed readily, but the patient died shortly afterward. The account of the autopsy is that: The cecum presented nothing extraor- dinary; it was covered with gangrenous patches. It was not the same with the vermiform appendix; I had scarcely opened it when we found a large pin, very rusty, and so corroded in certain places that the least touch would have broken it; a condition which proceeded, no doubt, not only from moisture, but from the acrid nature of the material enclosed in the ^'ermiform appendix. After what I have just said, it is easy to understand (although the patient had never spoken of swallowing a ])in) that the one under discussion had been concealed for a long time in the vermiform appendix of the cecum; and that it was undoubtedly this which had irritated the different coats of which the organ is composed, and had given rise to all the patient's symptoms, finally causing the death which ensued, t In the year 1766, Joubert La!\iotte, a student of medicine at the University of Angers, published a paper entitled Ouverture du cadmre d'vne personne morte d'une tympanite/' This patient suffered for some months before death with attacks of violent colic, the result apparently of an intestinal obstruction, since it is stated that purgatives could not pass, and enemas returned unchanged. The intestines, the writer goes on to say, were so inflated that the mesentery and the mesocolon (the glands in which were completely obstructed) were as tense as the skin of a drum. The size of the large and small intestines was nearly the same, and the cecum was so large that it exactly resembled an immense bladder filled with air. Its vermiform appendix, which was a good inch [' ?m bon * Edebohls, in his excellent Review of the History and Literature of Appendicitis, cites this case as that of a woman in the eighth month of pregnancy; but the reference has been carefully verified, and the facts found as noted. t Pee historical bibliography at the end of the third chapter (page 52) for all references contained in the first three chapters.