Appendicitis / by A. H. Tubby.

  • Tubby, Alfred H. (Alfred Herbert), 1862-1930.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Appendicitis / by A. H. Tubby. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    abnormal material, so it seems that the case quoted does not altogether bear out his contention, nor is it possible to quote with any certainty a case of somewhat similar nature which I have met with recently. It was that of a lady aged forty, who five days previously to my seeing her began to suffer from pain in the right iliac fossa and occasional vomiting and obstinate constipation. She was placed in bed, and given opium by her medical attendant. When I saw her she was free from pain; there was no rise of temperature; her pulse was 80, and beyond constipation and the feeling of heaviness in the right iliac fossa, she felt quite well. On examining the right iliac fossa, I could distinctly make out a mass which gave one the impression of impacted faeces. It had a doughy feel, and there was con- siderable tenderness about the mass. She was removed to Westminster Hospital, where Dr. Allchin kindly saw her with me. He thought the nature of the case was a peri- typhlitis arising from septic absorption of retained faeces in the caecum, and we decided to treat her by enemata; this brought away a large quantity of faeces : all pain and trouble soon subsided, and there has been no recurrence. It is not at all improbable that the long retention of faeces in the caecum may rouse into activity the virulent properties of the Bacillus coli communis, so that septic absorption may take place, and protective inflammation may occur in the peritoneum in the neighbourhood. But I should not be prepared myself to dogmatize about any case being caecal or appendicular in origin unless the appendix had been re- moved and carefully examined to show that no disease was present in it. thickening of the whole wall, and the other of a circular granulating ulcer of the mucosa. There was no enterolith. A similar case occurred to the author—that of a little girl aged eleven, who had had six attacks of appendicitis. Externally and before removal the appendix appeared slightly thickened only, but on slitting it open there was a stricture at its centre, and behind it a spot where the wall was so thin that it was formed only of peritoneum.