Appendicitis by John H. Tilden (life books to read txt) π
APPENDICITIS
CHAPTER I.
This cut represents the back view of the cecum, the appendix, a partof the ascending colon, and the lower part of the ileum, with thearterial supply to these parts.
"A, ileo-colic artery; B and F, posterior cecal artery; C,appendicular artery; E, appendicular artery for free end; H, arteryfor basal end of appendix; 1, ascending or right colon; 2, externalsacculus of the cecum; 3, appendix; 6, ileum; D, arteries on thedorsal surface of the ileum."--Byron Robinson.
The reader will see how very much like a blind pouch the cecum is,2. The ileum, 6, opens into the cecum, all of the bowel below theopening being cecum, the opening of the appendix, 3, is in the lowerpart of the ce
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If all cases are to be so abused and if there were no better way to treat them I also should say, operate at once as soon as the disease is discovered; but I know from years of experience that there is a better way to care for these patients.
Allow me to repeat: As soon as a case is diagnosed the proper treatment is to stop all medicine and food, for they excite movement, and this should be avoided. Give nothing but water. Keep ice over the inflamed spot. Keep the patient quiet, end the feet warm. There is absolutely nothing to be done until the bowels move, which will take place in from fourteen to twenty-eight days. The patient will not starve to death, nor will there be any danger that the abscess will open anywhere except into the bowels. After the bowels move, one glass of hot milk is to be given three times a day, so there will be no danger of solid food finding its way into the cavity of the abscess.
To be safe I insist on a fluid diet for a week after the bowels move, and a light diet for two or three weeks more. Cases taken through in this way, and then instructed in never allowing the bowels to become loaded again, will not only make a good recovery, but there is no tendency for the disease to return if the patient is prudent. I say that there need not be a death from this disease if these suggestions are properly carried out. The cases that die every year are killed by food and medicine.
Surgery has gained its reputation in these cases because of the stupidity of the average physician and patient. Cases taken through in this way are comparatively comfortable; they may pretend to suffer from hunger, but it is principally imagination. If my plan were generally adopted the dread of this disease would disappear; surgeons would get left on some fat fees, and the undertaker would look glum after the fall crop.
There are a few laymen so willful and incorrigible that they canβt be depended upon to follow instructions. They will break rules, be imprudent in eating, and in many ways disregard their own interests. Such cases should be sent to the surgeons as early as possible, before they have time to complicate their disease and make a complete recovery impossible; however, people with such temperaments usually find an early grave and they might as well go by the surgical route as any other.
End of The Project Gutenberg Etext of Appendicitis: The Etiology, Hygenic and Dietetic Treatment by John H. Tilden, M.D.
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