Further observations upon the etiology, diagnosis and treatment of acute and chronic appendicitis : with the report of sixty-one chronic cases operated upon, with one death / by John B. Deaver.

  • Deaver, John B. (John Blair), 1855-1931.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Further observations upon the etiology, diagnosis and treatment of acute and chronic appendicitis : with the report of sixty-one chronic cases operated upon, with one death / 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.

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    catarrhal inflammation, while the bulk of acute cases is due largely to foreign bodies, i. e., fecal con- cretions and extraneous substances. I have only seen two cases in which real foreign bodies were not found. In one, an acute case, the appendix con- tained a large number of strawberry-seeds; in the other, a chronic case, the appendix had contained a date-seed which had escaped at the point of ulcera- tion. It was found above the tip of the appendix, which pointed north and lay behind the colon. I believe that all cases of appendicitis begin as a catarrhal inflammation, in which the bacterium coli commune plays an important causative role. After this inflamed condition of the appendix has been established, the future outcome of the case, pathologically, very frequently depends upon the presence of a fecal concretion or foreign bodies and bacteria of suppuration other than the bacte- rium coli commune. No definite rule can be laid down, because there are cases that illustrate both conditions. It has been my experience that in acute perforative, and frequently in non-perforative, cases fecal concretions were found to exist either within the organ or in its immediate neighborhood. I have already made the statement that the diag- nosis of appendicitis is not difficult in the vast ma- jority of cases. I am now more than ever con- vinced of the truth of this statement and of the importance it bears to successful treatment. I he history of the case and the localized signs that center around that most valuable landmark known as McBurney’s point are always sufficient to estab- lish the diagnosis either directly or by exclusion.