Appendicitis | Page 9

immediate and exciting cause may be anything capable of laying on the

"last straw."
The micro-organisms are present wherever there is life and are as
necessary to life as they are to death.
Ochsner states that in nearly all instances the disease can be traced to
the common colon bacillus, which is always present when the intestine
is normal. The three pus cocci are sometimes blamed, and so are the
bacilli of typhoid fever, tuberculosis and the ray fungus (so-called
cause of lumpjaw).
Other causes given are: Edema and congestion closing the lumen of the
appendix, thus preventing drainage; constipation; digestive
disturbances; traumatism; eating too freely while in an exhausted
condition.
"Whatever the predisposing causes may be in any given case, the
exciting cause is always some infectious material. The colon bacillus is
always present in the lumen of the alimentary canal and, although it is
harmless under normal conditions, when these conditions arc changed
and there is an abrasion, an abnormal condition of the circulation, or a
lack of drainage, it becomes at once actively pathogenic. With a
perfectly normal peritoneum a considerable quantity of a pure culture
of colon bacilli may be injected into the abdominal cavity without
causing any harmful effect, as has been shown by the experiments of
Ziegler, but if there is any disturbance in the circulation or nutrition of
the peritoneum, the same quantity taken from the same culture will give
rise to a dangerous peritonitis."--Ochsner. [This goes back to the
constitutional derangement. First of all low resistance, then any
exciting cause is sufficient.]
In studying the cause of organic disease, the first thing to consider is
the organ itself. A knowledge of its structure and function will indicate
what diseases it is liable to have--what the character of the disease must
be.
Reason would say that an organ can be deranged in two general ways,
namely: structurally and functionally. In a structural way it may be

impaired either by coming in violent contact with extraneous objects,
or it may be crowded or pressed upon by enlarged or displaced
associate organs. In a functional way the derangement may be brought
about from overwork or underwork. A digestive organ may be
overworked by being given too much food, or food of too stimulating a
quality; or the over-stimulation may come from poisons coming into
the food from without or developing in the food after its ingestion. The
bowels may be injured by coming in violent contact with external
objects. When this is the cause there will be the history of accident, etc.
The functions of the bowels are to furnish a dissolving fluid which is
secreted by glands situated in their structure and opening into their
lumen; besides the secreting glands they are provided with power to
excrete and absorb. The organs for the accomplishment of these
purposes, like the secretory glands, are situated in the structure and
open into the canal. Besides the functions of secretion, excretion and
absorption, the bowels act as the great sewer of the body.
The dissolving fluids, or digestive fluids, have the power to overcome
fermentation when the general health standard is normal; when the tone
of the general health is lowered these digestive juices are lacking in
power; hence they are not able to control fermentation if food be
ingested to the amount usually taken in health. The power to oppose
fermentation by the digestive juices ranges all the way from nil to the
resistance usual to a man of full health and vigor.
It being the function of the bowels to digest food and overcome
fermentation, it stands to reason that to accomplish this function they
must be normal--they must have a proper supply of nerve force and the
supply of nutrition must be normal or they can not furnish the proper
amount and quality of secretions. To have all these needs supplied they
must be reciprocally related to every other organ associated with them
in the organic colonization which totals a human being.
On account of the reciprocal relationship between the bowels and the
rest of the colony of organs, the bowels must share alike; that is, in the
matter of distribution of forces no organ of the body can be favored; all
must go up and all must come down together. They must all share alike;

hence the bowels have their share of the general tone and, if they are
required to do more than a reciprocal amount of the work, it stands to
reason that they can not do good work; and, if they can not do good
work, the whole colony must suffer in a general way, while the bowels
must also suffer in a special way. The function of drainage or sewerage
is very important, and the perversion of it brings on much ill health.