APPENDICITIS

Evening Post, Volume CXXI, Issue 130, 3 June 1936, Page 8

APPENDICITIS

(To the Editor.)

Sir—lt is particularly unfortunate that "Medicus"' in his letter of June 1 should have quoted the case of King Edward VII because I hold in my hand and am going to quote an oration delivered by a personal friend of mine and sent by him to me in 1932. It is the annual oration delivered before the Medical Society of London in May, 1931, by Sir James Berry, Bart., a very distinguished London surgeon. It is entitled "Fallen Idols," and is particularly directed to the over-proportion of surgical operations fashionable during the last two or three decades. He is quoting Sir Frederick Treves and referring to his Majesty, and on page 275 (reprinted from the Transactions of the Medical Society of London, Vol. LV), he states:—"Of the first case I shall be able/later on, to tell you something which is apparently not' generally known by the present generation of medical men, still less by the general public. It has been well known to me for thirty years, and after this long lapse of time I think that, in the public interest, it is only right that it should be known. "I have not the slightest doubt that his Majesty owed his life to the wise discretion and skilful treatment—perhaps I should rather say the wise avoidance of any active treatment until the right time was judged to have comc for surgical interference." And on page 276 he goes on as follows: "And what was the operation? All the world knew that it was an operation for appendicitis, that the King made a good recovery, and that he lived nearly eight years longer, and that he never had any recurrence. Few people knew even at that time that his appendix Was not removed, that, no search for it was ever made, that it was neither seen nor felt." And further on: ''Wb3t , would have happened had this case oc-

curred twenty-flvc years later, under the influence of the modern teaching that an appendicitis patient should be operated upon as soon as he is seen by the surgeon, and the sooner the better?"

Later on the lecturer sums up: "After a large experience of cases that I have seen, treated by both methods, and still more that have been related to me, I have but little doubt that the patient (i.e., the King) would have had but little chance of surviving as long as ]( eight days, to say nothing of eight years. There is no little irony in the fact that the popularity of the modern operation is largely based upon ignor- c ance of what was really done at this w famous operation." I could give figures quoted by Sir James Berry to show that total deaths from appendicitis and perityphlitis in . England and Wales jumped up from 8291 for the five years 1901-05 to 14,105 for the five years 1926-30: The total deaths from appendicitis in 1930 were 2941, nearly 3000. I have quoted this j] at some length because I thought it c might be of some general interest at the present time. —I am, etc., OSCAR JACOBSEN. a