Appendicitis | Page 5

become popularly known until about
twenty years ago--not till it was christened and baptized in the blood of
the surgical art. Of course the appendix has always been subject to
inflammation, just as it is now, but in former years the disease we call
appendicitis bore various names, depending upon the diagnostic skill of
the attending physician. Typhlitis and perityphlitis were the names used

to designate the disease now covered by the word appendicitis.
The diseases that appendicitis may be confounded with and must be
differentiated from are obstruction, renal colic, hepatic colic, gastritis,
enteritis, salpingitis, peritonitis due to gastric or intestinal ulcer,
enterolith, obstipation, invagination or intussusception, hernia, external
or internal, volvulus, stricture and typhoid fever.
The old text-book description of typhlitis and perityphlitis is so similar
to the description of the present day appendicitis that it is not necessary
to reproduce it. The symptoms given show conclusively that they are
really one and the same.
In the surgical treatment of appendicitis the American profession has
taken the lead, and the mention of this disease brings to mind such
names as McBurney, whose name is given to an anatomical
point--McBurney's Point--midway between the right anterior superior
spine of the ileum and the umbilicus, Deaver of Philadelphia, and
Ochsner and Murphy of Chicago. Those who are interested in the
surgical treatment of the disease can look into the methods of these
men, and many others. The medical literature of the day abounds in
exhaustive treatises on the subject of appendicitis and its surgical
treatment.
We are living in an age that will not be properly recorded unless it be
entered as _The Age of Fads._
Following immediately on the announcement of Lord Lister's antiseptic
surgical dressing which rendered the invasion of the peritoneal cavity
comparatively safe, came the laparotomy or celiotomy mania. When it
was discovered that opening the abdomen was really a minor operation,
it was soon legitimatized by professional opinion, and rapidly became
standardized as a necessary procedure in all questionable cases--in all
obscure cases of abdominal disease--where the diagnosis was in doubt.
The result of popularizing and legitimatizing the exploratory incision,
was to cause those who failed to resort to it, in doubtful eases, to be in
contempt of the court of higher medical opinion, and to license those of
a reckless, selfish, savage nature to play with human life in a manner

and with a freedom that would make a barbarian envious.
The wave of abdominal operations that swept the country in the last
quarter of the nineteenth century was appalling. The slightest pain
during menstruation, or in the lower abdomen, in fact every pain that a
woman had from head to toes was put under arrest and forced to bear
false witness against the ovaries. It was a very easy matter to trump up
testimony, when real evidence was embarrassing, to foregone
conclusions; hence pains in obscure and foreign parts took on great
importance when analyzed by minds drilled in the science of nervous
reflexes, sympathies and metastases.
Normal ovariotomy (removing normal ovaries for a supposed reflex
disease) swept the whole country during the eighties and threatened the
unsexing of the entire female population. The ovaries had the
reputation of causing all the trouble that the flesh of woman was heir to.
Oophorectomy was the entering wedge, since then everything
contained in the abdomen has become liable to extirpation on the
slightest suspicion.
Those surgeons of greater dexterity or savagery, I can't tell which,
prided themselves in operating on the more difficult cases. Taking the
ovaries out was a very tame affair compared to removing the uterus,
tubes and ovaries; hence the surgical adept embraced every opportunity
for an excuse to remove everything that is femininely distinctive.
About 1890 appendicitis began to attract the attention of those
surgically ambitious. The ovariotomy or celiotomy expert began to feel
the sting of envy and jealousy aroused by those who were making
history in the new surgical fad--appendectomy--and they got busy, and,
as disease is not exempt from the economic law of "supply always
equals demand," the disease accommodatingly sprang up everywhere;
it was no time before a surgeon who had not a hundred appendectomies
to his credit was not respected by the rank and file, and an aspirant for
entrance to the circle of the upper four hundred could not be initiated
with a record of fewer than one thousand operations.
Thanks to the law of supply and demand the ovaries retired and gave

women a much needed rest. If they had continued to misbehave as they
had been doing before the appendix got on the rampage, the demand for
surgical work would have exceeded the supply of surgeons. Diseases of
all kinds are very accommodating; as soon as a successful rival is well
introduced they retire without the least