Appendicitis.
- RUDDOCK.E.H,
A DEFINITION-Inflammation of the appendix vermiformis, due to bacterial infection of its lining membrane.
Except in the mildest forms of catarrh of the appendix peritoneum covering it,a nd if the peritoneum fail to react or the infection be virulent, this localized peritonitis may rapidly spread until the condition of general peritonitis is set up.
An important result of catarrh with stagnation of contents in. the appendix is the formation of appendicular concretions. These concretions often bear a resemblance to date stones, plum stones, or orange-pipes. but contrary to the popular belief, it is extremely rare for any recognizable foreign-body, which has been swallowed with the food, to be found in the appendix.
Although appendicitis is chiefly a disease of youth, and occurs with greatest frequency between the ages of ten and thirty, it may e met with at any period of life. It is more common in the male than in the female, and usually occurs in those who are apparently in good health, although in some cases it may all follow upon constipation or an antecedent catarrh of the bowel. assigned as a cause of appendicitis is rather to be regarded as a factor which may light up inflammation in an appendix that is already diseased. Certain formalities show a predisposition to appendicitis the comparative immunity of races whose diet is largely vegetarian would suggest that the disease is in some way related to the eating of meat.
SYMPTOMS-The patient experiences a sudden sharp griping pain in the abdomen, usually referred to the navel,and followed by nausea and it may be vomiting. It time the pain and tenderness become localized to the right side of the belly,. below other level of the navel. Soon after the onset the temperature begins to rise, and at the end of eight or twelve hours reaches 10 degree r 101 degree F. the pulse is accelerated 90 to 100). the bowels do not move, and no flatus is passed.
If the infection is confined to the appendix he pain gradually passes off and the symptoms subside in. the course of from twelve to thirty-six hours, and nothing mains but a little tenderness in the region of the the appendix.
If one the other hand the infection spread to the peritoneum, the pain persists and becomes more severe, the belly-wall in the right lower quadrant ceases to move with respiration, becomes rigid from muscular contraction,a and excessively tender to touch. the symptoms go general illness continue, vomiting may persist, the temperature, remains elevated and the pulse quickened.
At this stage also the progress of the disease may become arrested and the severity of the illness-abate. On the other hand suppuration may occur and an abscess form, which if left to itself will bust on the skin surface or internally. If the infection reach the peritoneum before adhesions wall it off, it tends to spread widely and the phenomena are those or diffuse peritonitis. the s symptoms are more severe and progressive, and tonic symptoms assume a graver type. The feature become drawn and pinched, and the expression anxious. Vomiting is usually persistent and occurs without retching. the abdominal wall is contracted and does not move on respiration. The patient may die within thirty-six hours of the onset of the illness, and often fails to realize the gravity of his condition.
TREATMENT-There is unfortunately no means of determining in any given attack whether it is going to subside or not. By early operation the patient is relieved without risk, without danger of a prolonged illness, and of unpleasant sequelae, and without the possibility of recurrence.
Aconitum-Predominance of febrile symptoms. A dose every hour till relief is experience. It is also acquired early in he disease, in alternation with any other remedies selected. A low dilution should be used
Bryonia -Stinging and burning pains, greatly increase on movement; constipation, general uneasiness, etc.
Mercurius Cor-Sallow skin, yellow-coated tongue, and when Tympanitis and Abscesses occur.
Belladonna-Brain disturbance-headache,e flushed face, throbbing, etc. A few doses usually suffice.
ACCESSORY MEANS-Hot fomentations to the abdomen to relieve pain; perfect quiet; frequent sips of hot water. Enemata of hot water 9up to two pints at a temperature of 105 degree F. ) When the acuteness of the attack is passed mild, unstimulating diet, and some cases cold compresses do more good than hot fomentations. Belladonna or Veratrum vir. may be applied locally.
RECURRENT Appendicitis - A first attack of appendicitis is followed by reoccurrence in a proportion of cases. After the original attacks the patient may remain well for weeks, months, or even years, before being troubled again, or the attacks may recur at short intervals, so that he is never really well and is unable to continue his occupation.
The removal of the appendix after a first attack of appendicitis is indicated if the patient wishes to insure his life;l if he desire to enter one of the public services; if he is compelled to reside where he is out of reach of surgical assistance. Operation is advisable also in children and young adults, because if recurrence rakes place it is often of grave type. The operation is as a rule of simple one.
A DEFINITION-Inflammation of the appendix vermiformis, due to bacterial infection of its lining membrane.
Except in the mildest forms of catarrh of the appendix peritoneum covering it,a nd if the peritoneum fail to react or the infection be virulent, this localized peritonitis may rapidly spread until the condition of general peritonitis is set up.
An important result of catarrh with stagnation of contents in. the appendix is the formation of appendicular concretions. These concretions often bear a resemblance to date stones, plum stones, or orange-pipes. but contrary to the popular belief, it is extremely rare for any recognizable foreign-body, which has been swallowed with the food, to be found in the appendix.
Although appendicitis is chiefly a disease of youth, and occurs with greatest frequency between the ages of ten and thirty, it may e met with at any period of life. It is more common in the male than in the female, and usually occurs in those who are apparently in good health, although in some cases it may all follow upon constipation or an antecedent catarrh of the bowel. assigned as a cause of appendicitis is rather to be regarded as a factor which may light up inflammation in an appendix that is already diseased. Certain formalities show a predisposition to appendicitis the comparative immunity of races whose diet is largely vegetarian would suggest that the disease is in some way related to the eating of meat.
SYMPTOMS-The patient experiences a sudden sharp griping pain in the abdomen, usually referred to the navel,and followed by nausea and it may be vomiting. It time the pain and tenderness become localized to the right side of the belly,. below other level of the navel. Soon after the onset the temperature begins to rise, and at the end of eight or twelve hours reaches 10 degree r 101 degree F. the pulse is accelerated 90 to 100). the bowels do not move, and no flatus is passed.
If the infection is confined to the appendix he pain gradually passes off and the symptoms subside in. the course of from twelve to thirty-six hours, and nothing mains but a little tenderness in the region of the the appendix.
If one the other hand the infection spread to the peritoneum, the pain persists and becomes more severe, the belly-wall in the right lower quadrant ceases to move with respiration, becomes rigid from muscular contraction,a and excessively tender to touch. the symptoms go general illness continue, vomiting may persist, the temperature, remains elevated and the pulse quickened.
At this stage also the progress of the disease may become arrested and the severity of the illness-abate. On the other hand suppuration may occur and an abscess form, which if left to itself will bust on the skin surface or internally. If the infection reach the peritoneum before adhesions wall it off, it tends to spread widely and the phenomena are those or diffuse peritonitis. the s symptoms are more severe and progressive, and tonic symptoms assume a graver type. The feature become drawn and pinched, and the expression anxious. Vomiting is usually persistent and occurs without retching. the abdominal wall is contracted and does not move on respiration. The patient may die within thirty-six hours of the onset of the illness, and often fails to realize the gravity of his condition.
TREATMENT-There is unfortunately no means of determining in any given attack whether it is going to subside or not. By early operation the patient is relieved without risk, without danger of a prolonged illness, and of unpleasant sequelae, and without the possibility of recurrence.
Aconitum-Predominance of febrile symptoms. A dose every hour till relief is experience. It is also acquired early in he disease, in alternation with any other remedies selected. A low dilution should be used
Bryonia -Stinging and burning pains, greatly increase on movement; constipation, general uneasiness, etc.
Mercurius Cor-Sallow skin, yellow-coated tongue, and when Tympanitis and Abscesses occur.
Belladonna-Brain disturbance-headache,e flushed face, throbbing, etc. A few doses usually suffice.
ACCESSORY MEANS-Hot fomentations to the abdomen to relieve pain; perfect quiet; frequent sips of hot water. Enemata of hot water 9up to two pints at a temperature of 105 degree F. ) When the acuteness of the attack is passed mild, unstimulating diet, and some cases cold compresses do more good than hot fomentations. Belladonna or Veratrum vir. may be applied locally.
RECURRENT Appendicitis - A first attack of appendicitis is followed by reoccurrence in a proportion of cases. After the original attacks the patient may remain well for weeks, months, or even years, before being troubled again, or the attacks may recur at short intervals, so that he is never really well and is unable to continue his occupation.
The removal of the appendix after a first attack of appendicitis is indicated if the patient wishes to insure his life;l if he desire to enter one of the public services; if he is compelled to reside where he is out of reach of surgical assistance. Operation is advisable also in children and young adults, because if recurrence rakes place it is often of grave type. The operation is as a rule of simple one.
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