WHAT THE Kip IS SUFFERING FROM.

New Zealand Herald, Volume XXXIX, Issue 12002, 26 June 1902, Page 6

WHAT THE Kip IS SUFFERING FROM.

SOME PARTICULARS OF THE COMPLAINT. INTERVIEWS WITH AUCKLAND DOCTORS, £OW THEY REGARD IT. THE OPERATION DESCRIBED. With the view of obtaining some particulars regarding the disease from which His Majesty is stated to be suffering, a representative of the Herald interviewed a number of the leading medical men in Auckland yesterday. The information gained was much the same in each instance, viz., that perityphlitis or appendicitis consists of an inflammatory condition of tho vermiform appendix, and that it is a common disease, mainly confined to young people, and one which very frequently necessitates an operation being performed, such as has been undertaken in the case of the King.

The first doctor seen on the subject made tho following statement:—Perityphlitis—assuming that this is the complaint from which tho King is sufferingis very unusual with persons so advanced in years. It is an inflammation around that part of the intestines known as the caecum, and is very often due to tho lodgment of some foreign substance in a blind gut or appendix to the main bowel. This is called the appendix vermiformis, and although it is- a structure which always exists in tlio human body, it seems to serve no useful purpose." " Is the disease dangerous?"

" It is, for the reason that there is a risk of the inflammation spreading to the general cavity of tho abdomen. Such an occurrence would be most serious. The fact that an operation has been undertaken is suggestive of tho attack being an acute one. As to possible complications, ono must be prepared at the age of 61 to consider in connection with tho present trouble the question of that malignant disease, cancer, a strong tendency to it having already shown itself in two members of the Royal family, viz., the late Empress Frederick and the late Duke of Saxe-Coburg and Gotha. There is no doubt that one must look forward with considerable apprehension to tho events of the next few days." " How long should it take to recover from the operation?" " If tho operation is successful, and there are no unusual complications, one may expect the King to bo about again in a couple of months."

Another doctor, after referring to tho disease as one of the most acute of intestinal disorders, described it in words similar to those used by tho first practitioner interviewed. Questioned as to the causes of the complaint, he said: " The causes are rather obscure. Formerly it was thought to be duo to inflammation of the caecum and of the peritoneum covering it, but we now know that with rare exceptions the cjecutn is not ; affected. One cause may be the lodgment in the appendix of a portion of hard indigestible food, such as a grape stone, but it is more frequently due to causes arising in the appendix itself." " Does the disease often terminate fatally?" "On an average, more than 50 per cent, of the patients recover, but it must be borne in mind that, generally speaking, the disorder is a complaint of young people, cases in which elderly persons are attacked being! rare. Of 261- cases treated in St. Thomas' Hospital. London, 190 recovered. When death occurs from appendicitis it is usually due to general peritonitis, which is an inflammation of the lining membrane of the abdomen, supervening.'' " Are there any other complications which are likely to arise ?" " I think not. That is, nothing direct." " What would probably be the purpose of the operation on the King '.'" "As one of the cablegrams indicate it would probably be to evacuate an abscess, which is a usual accompaniment of the complaint. Very frequently, in these cases, an operation is performed for the removal of the appendix itself, which, as I have already told you, fulfils no well-defined function." " What length of time do you expect to elapse before His Majesty's recovery?" .'•tj:? 1°- ftf?E momhVquite, ocfuro "he i 3 > - re? ,£ored 'to bis usual health. Of course his age and build is an important consideration in this calculation." "I understand that perityphlitis and ap. pendicitis are one and tho same disease?" "Yes; perityphlitis is the older name. Any distinction which may bo made is merely technical." . Another doctor, after giving a similar description of the complaint, took a rather more serious view of tho King's condition. "I should," he said, " look upon tho case as being very critical, in view of tho King's age and build. With young people you may get very good results, but there are always considerable risks in a disease of that kind, especially with elderly people. The case may go on very satisfactorily for a few days and then serious symptoms may set in even in apparently favourable cases, so that it does not do to expect too much. Complications might arise and lead to a spread of the inflammation. General peritonitis, for example, might supervene, and this would be very serious. Stoppage of the bowels also is by no means unlikely." '* How soon may a recovery be expected?" " If all goes well and no complications arise within a week or 10 days, there will be very good chances that the King may be comparatively, if not perfectly, well in a. few weeks." The next doctor to whom similar questions were put took a less serious view of the situation, remarking that the complaint was a very well-known condition. " A very large number of people in Auckland who will read the reports of your interviews on the subject, will unfortunately, understand from experience what the King is suffering from. The complaint is a well-recognised one, .and is described in all medical text-books nowadays. It may occur with or without suppuration. When there is suppuration the formation of an abscess renders an operation necessary for its evacuation. In all probability this has been the history of the King's case. His trouble may have first made itself evident in pains near the back, which would perhaps account for the report lately mentioned in the cablegrams that His Majesty was suffering from lumbago." " What result do you expect from the operation?" The operation is a critical matter at the King's time of life, but the case, I should say, is one that is well within the power of His Majesty's skilled surgeons to deal with. There may be every hope that the operation will be quite successful." " Could you describe the operation usually performed in such cases?" "I could, but it is difficult to make such matters intelligible to the lay mind. Briefly, the operation consists in making an incision over the appendix, which is on the right side of the body. The removal of the abscess is not merely a question of putting a knife into it. Great care has to be exercised, as there are important organs, amongst which the pus may have formed, and in such case there is a danger of trouble. The appendix is not always removed at the time of a first attack. A man may take appendicitis and recover without an operation, but in these instances operations for the removal of the appendix are often undertaken to avoid the risk of a second attack."

A fifth doeor said that the existence of an abscess indicated that the King's case was a serious one, and he also pointed out the (possibilities of other disordersmalignant or otherwisein the region of the bowels. He considered that at least six or eight weeks must elapse, should the case proceed favourably, before the King will be himself again. One other doctor was interviewed, and he also dwelt upon the frequency of the complaint and the disturbances which arise from that important, although functionless, pari of the human anatomy, the appendix vermiformis, which is supposed by many to be a relic of pre-hi.storie times, when our forelathers ate grass and did other -things quite as unknown in these advanced days of the P.Otr century. Ho stated that appendicitis might be caused by a cold or a blow, and that in many cases it was very difficult to say how it was caused. He considered that there must have been an emphatic necessity for an operation at such a time, and that it would be two or three months before His Majesty would be able to stand tho strain of a Coronation ceremony.

"The Principles and Practice of Medicine" (Osier) contains the following:—" Appendicitis is a disease of young persons. According to Fitz's statistics more than 50 per cent, of th© cases occur before the 20th year; according to Einliorn's 60 per cent, between the 16th and ZQth year. It has been met with as early as the seventh week, but it is rarely seen prior to the third year." The writer adds that the complaint is more common in males than females, and that persons whose work consists in lifting heavy weights seem especially prone to the disease. In a number of cases the symptoms closely followed a fall or a blow.