THE CAUSE OF APPENDICITIS.

Wairarapa Daily Times, Volume XXIX, Issue 8037, 9 January 1905, Page 2

THE CAUSE OF APPENDICITIS.

Why is appendicitis so common, at the present time ? This affliction spares neither age nor sex, is equally dreaded in palace and cottage. The King has been among its victims, nor has it neglected even the pitiable vagrant. The idle girl without definite employment succumbs, as also does the soldier on active service. The schoolboy is particularly prone, and the affection does not ignore the dignitary of the church. Can it be, asks a writer in k the National Review, who is a Fellow the Royal College of Surgeons, that small blind tube placed within the abdomen has suddenly become vulnerable to £S3ault, or is it that there is some peculi arly potent force now at work which did not formeriy exist ? The writer says it is not to be denied that more accurate diagnosis has led to an apparent increase in the number of cases of the complaint. Peritonitis, or inflammation of the lining membrane of the ab-omen, has always been a common and a dreadful malady, but the precise cause of the inflammation has been frequently entirely overlooked in the paßt, and to-day it is the opinion of most medical practitioners that consider- ._ ably more than one-half of the casts of M peritonitis are primarily attributable to an inflammation o! the vermiform appendix. To review some of the known causes of appendicitis and see how they may be avoided is the object of the writer in the Review. It will doubtless be a source of relief to many of our readers, more particularly at this season of the year, to hear that the idea that fruit stones and pips of all sizes, from the cherry-stone to the small appJe-pip, are liable to enter the cavity of the apppndix and there cause havee, has little foundation in fact. As regards the cherry-stone, the medical authority asserts that this is pure fiction, as may be gathered from the fact that the entrance of the tube, which has a larger diameter thaa any other part, will hardly admit in the normal state the top of an uncut cedar pencil. That smaller foreign bodies may gain access to the interior of the tube is undoubtedly true, but the number of instances in which such have been discovered within the diseased appendix is comparatively small. A single duckshot, a small fragment of solder from a canned meat tin, a bristle from a tooth brush, a spicule from the lining of an enamelled saucepan, and an ordinary pin, have all been known to find their way into the interior of the appendix, and once there such bodies may undoubtedly induce inflammation. But there is a more cemmon cause for the frequency of the af- r* fection. The human body is constantly 1 harbouring micro organisms, which are ever ready to attack the tissues, and are especially capable of doing so when a person is below par, or the particular tissue with which they are in contact has suffered some injury. These micro-organisms, styled bacteria, are constantly taken in with food, and more particularly so in towns. Being perpetually reinforced, they are continually multiplying, and able to attack any undefended point. Tbre is perhaps nothing which so tends to as&ist their multiplication and to increase their virulence as hurried and irregular meals, involving the retention of imperfectly digested food. Then it is that theEe microscopical organisms will crowd into what may be called the backwater of the appendix, here to stagnate and develop a powerful poison which, acting upon the walls of the tube, soon produce inflammation, which is evidenced by pain and all the train of symptoms incident to appendicitis. The moral is, says the medico, to eat one's meals deliberately, leaving time for the commencement of the process of digestion before imposing undue strain on the muscles by rushing away to one's dutiee, or the mental faculties by any intelligent effort such as a smart financial transaction. The same resuits follow the young woman of inactive 4fl mind and body, eathag rich food often at late hours ; and the child of the poor, fed on atrociously unsuitable food, cannot hope to escape the attack of the ever-ready bacterial forces. It will thus be realised that the medical profession looks upon the modern life of rush, strain, and worry, with unwholesome diet and irregular habits, as one of the principal causes of the increase of appendicitis, and it believes that tht.se who wish to avoid this ailment must live more plainly, take matters more easily, and pay more attention to what Nature proclaims as a rational existence. One attack of appendicitis is liable to be followed by another at an unknown interval, and the survivor of the first may succumb to the second. As the writer suggests, much can be done to avoid the onset of the attack, and possibly even if it has come to a head, care in diet, regularity of exercise, and an intelligent well-ordered life may serve to postpone or even prevent a second prostration. The operative treatment of appendicitis has two main objects, viz., to relieve the urgent systems during the acute attack, and to prevent any possibility of a recurrence of the mischief. The . gravity of the operation necessitated during the attack by the urgency of the symptoms, arises, not so much from the operative measures themselves, but owing to the peritonitis which accompanies appendicitis. Should, however, the acute inflammation subside, an operation can then be under- ' v _B> taken to remove the offending organ. The operation, if skilfully performed, is really less dangerous to life than the ret-ntion of the tube, which is ever liable to a fresh incidence of inflammation, the result of which cannot be prophesied. The conclusion of the whole matter would, therefore, appear to be—avoid the obvious causes of appendicitis; have immediate professional attention on the first symptoms of an attack, and submit to the removal of the tube if so advised after the acute stage has been passed, so as to avoid the danger of any recurrence.