When shall we operate for appendicitis? / by Willy Meyer.

  • Meyer, Willy, 1858-1932.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: When shall we operate for appendicitis? / by Willy Meyer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    near the tip of a long appendix and its lower extrem- ity blown up, giving the whole vermiform a pear- shaped appearance. In a number of instances we have a certain apprehension, induced partially by in- creasing experience, partially perhaps by the patient’s irregular pulse, or his specially sick appearance, or his indifference, or his pale face and hollow eyes, although the pulse does not press us. Here too, we operate. But for the majority of cases of acute appendicitis I believe the above rule, if strictly adhered to, will generally enable us to be still on time. But in order to be “ on time” the patient must be carefully observed. After physician and surgeon have seen the patient, a nurse must stay at the bedside and take pulse and temperature from hour to hour, day and night. People who can afford it should always give in and call for a nurse at once. Poor patients should be sent to the hospital. If we do this as soon as the diagnosis has been established, we have done the best for the patient. It goes without saying that in observing these cases the use of opiates is abso- lutely excluded. Unfortunately there will always be a number of cases of acute appendicitis where even under this re- gime the operation, in order to be a timely one, will be done too late. In spite of it the patient dies. Therefore, if the attack is sharp, the pulse rising, and if we are in doubt what is best to be done, let us operate rather than wait, even in large cities like New York, where we can always be on hand on short notice. The country practitioner, who cannot see his pa- tient so often, will save more lives by always having his patients with an acute attack of appendicitis op- erated upon as soon as possible. A few remarks here, before I proceed, with refer- ence to the so-called “first attack.” It would, no doubt, be very wrong to believe that the first attack of inflammation really is the first pathological symp- tom which befalls the appendix. “ First explosion”