Appendicitis | Page 6

show of jealousy, showing that
they are not strangers to the highest ethics, their associations to the
contrary notwithstanding.
There are many well written articles on appendicitis, but I believe the
monograph by A. J. Ochsner, M. D., is decidedly the best, and when I
refer to the best professional ideas on etiology, pathology,
symptomatology and treatment I have in mind the opinions set down by
Ochsner, for he has taken more advanced grounds in the medical
treatment of this disease than any other physician I know anything
about in this or any other country. If his "A Handbook on Appendicitis"
brought out in 1902, had come out three years before, I should give him
credit for being the first man on record to proscribe the taking of food
in appendicitis, but as my first written advice on the subject was in the
July, 1900, number of A Stuffed Club,* two years before his book, I
shall give myself the credit for being the first physician to announce to
the world _the only correct plan of treating the disease and suggesting
the probable cause _which the intervening time has proven to be correct
The only reason I have for making this announcement is that in all
probability no one else will ever do so, and, as it is just and right that I
should have the credit, I do myself the honor. The general rule is that if
a new method of treatment comes out, or a discovery of importance is
made other than in the regular professional channels, it will either be
ignored or adopted (cribbed is more expressive) and no credit given.
This is a small matter, and of no special consequence, yet it carries a
meaning.
*(Editor's note: "A Stuffed Club" was the newsletter or journal
published by Dr. Tilden for many years.)
Previous to 1890 the most popular treatment was probably the giving of
opium; although this was far from ideal, "it had the advantage of taking
away the patient's appetite, relieving pain, and putting the bowels to

rest."--Ochsner. If there were any way to prove it, we should find that
next to surgery opium is still the most popular way of treating the
disease.
To-day there is no other disease which brings surgery so quickly to
mind as does appendicitis, especially if the victim can stand for a good,
large fee. It is only human I presume, for surgeons to defend the
operation. They believe in it, and are not willing to investigate, for they
are satisfied. They know or should know that ninety per cent of all the
surgery practiced to-day has no excuse for its existence--no more right
to be protected by the laws that weld society together than has any
other graft that exists by the grace of public ignorance and credulity.
This operation has for some time been the largest single item of
revenue for the profession.
Thirty-four years ago I was called in consultation to see my first case of
what was then generally recognized as perityphlitis or
typhlitis--inflammation of the connective tissue about the cecum. It was
a typical case of what is today called appendicitis. I advised the doctor
to cease his fruitless endeavors at securing relief by giving drugs, and
give the patient nothing but water. As I remember now, it took about
four weeks for this patient to recover. This plan--positively nothing but
water--has since been a part of my treatment in all such diseases.






CHAPTER III

_Etiology: _To understand the cause of appendicitis we must go back
to the beginning, and when we do we find that it starts just where all
diseases start, namely, _where health leaves off! _When the laws of
health are broken for the first time, it can be said that the individual has
started on the road of ill health. How fast he will travel and just what
will be the character of the disease he meets with will depend upon his
constitution, inheritance, environment and education. I do not mean by
education, school or book education; I mean intuition--that knowledge
which evolves from home life and habits. I mean, has he any
self-discipline? Does he know anything about self-denial? Has he any
conception of a control higher than impulse? Has he been brought up to
know that there is a limit to the gratifying of wants and desires beyond
which, if he goes, he must make good with laws that are as exacting as
they are invariable? Does he know that nature shows no favoritism?
Does he know that there are laws regulating his intercourse with
men--with everything--that exact absolute justice from him? And that,
if he takes advantage of weakness or ignorance because he can, or if he
secures an advantage through credulity or