Appendicitis by John Henry Tilden
page 68 of 107 (63%)
page 68 of 107 (63%)
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_"Autopsy:_ Normal condition of the scrosa above the omentum: the
appendix surrounded by adhesions embedded in fecal pus? gangrenous toward its terminal portion, and showing perforation; fecal calculus in the pus; appendix movable toward the cecum." [Just what may be expected in all cases! Nature is always busy reinforcing weak points, but the modern physician and surgeon is too wily and artful for her; she can't always anticipate his moves, hence she can't always fortify successfully.] "Agglutinated point of rupture at the median periphery of the cecum near the ileo-cecal valve. The perityphlitic pus appeared to be sacculated by adherent intestinal coils, but beyond the adhesions in the free abdominal cavity below the omentum there was diffuse, fresh, fibrinous peritonitis and distributed here and there small quantities of thin, putrid pus (many bacteria, large quantities of streptococci and cold bacilli). The peritoneum was injected. of a delicate rose-red color, here and there covered with fine, mucus-like pseudo-membranes. Heart flabby." [The autopsy showed nothing more than would be expected. The fresh peritonitis confirms what I say that a reinfection was forced because of the character of the food. The meteorism opposed relaxation and rest, two conditions positively necessary and without which healing can not take place. What was to hinder the heart from being flabby, Drugs and systemic infection are quite enough. In proper hands this young man would not have been very sick; possibly his trouble would have been thrown off and the inflammation passed off by resolution. |
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