Appendicitis in children / by John B. Deaver.

  • Deaver, John B. (John Blair), 1855-1931.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: Appendicitis in children / by John B. Deaver. 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.

    7/22
    ther predisposing cause, which may induce either a catar- rhal or an ulcerative type. Among the exciting causes may he mentioned the presence of seeds, enteroliths, faecal concretions, inspissated mucus, particles of undigested food, traumatism, and exposure to cold or dampness, but the most frequent exciting cause is the result of a previous attack. History and Symptoms.—The onset is usually sudden, constipation the rule rather than the exception. We may be able to elicit a history of one or more previous attacks or of the rapid ingestion of some indigestible substance or overloading of the stomach. The symptoms of appendicitis in its incipiency are not by any means definite in all cases. The prominent and constant symptoms are pain, vomiting, and tenderness. The pain, which is at first paroxysmal, in this respect re- sembling colic, is referred to the umbilical and epigastric regions, and in seventy-two per cent, of all cases appears within twenty-four hours. Later it becomes continuous, and is localized in the right iliac fossa in fifty-four per cent, of all cases. Vomiting is present from the first, be- coming uncontrollable if the case does not yield to treat- ment. The vomited matter consists first of the contents of the stomach, later of bile, and finally, if a plastic peritonitis supervenes by which the coils of intestine are immobilized from the resultant deposit of lymph, of stercoraceous mat- ter in those cases in which the. intestinal tract has not been emptied. Ordinarily the. vomiting of stercoraceous matter is indicative of acute intestinal obstruction, yet we see stercoraceous vomiting in advanced and hopeless cases of appendicitis. The tongue is furred and later in the dis- ease becomes dry with the deposit of sordes upon the teeth. There is extreme thirst, with a temperature va- rying from 102° to 104° F. and a high pulse rate. The