Diseases of the intestines, their special pathology, diagnosis, and treatment : with sections on anatomy and physiology, microscopic and chemic examination of the intestinal contents, secretions, feces and urine intestinal bacteria and parasites; surgery of the intestines; dietetics, diseases of the rectum, etc / by John C. Hemmeter.

  • Hemmeter, John C. (John Conrad), 1863-1931
Date:
1902
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Licence: In copyright

Credit: Diseases of the intestines, their special pathology, diagnosis, and treatment : with sections on anatomy and physiology, microscopic and chemic examination of the intestinal contents, secretions, feces and urine intestinal bacteria and parasites; surgery of the intestines; dietetics, diseases of the rectum, etc / by John C. Hemmeter. Source: Wellcome Collection.

    24/688 (page 20)
    TYPHLITIS WITHOUT APPENDICITIS. lie collected in the first paper 209 cases, and those of perforating appendicitis, of which he collected 257 cases, were almost identical. I shall speak more fully of this publication under the heading Per- forating Appendicitis. In the second report of 1888, Fitz advanced the radical theory that typhlitis, perityphlitis, appendicular periton- itis, and perityphlitic abscess are all varieties of one and the same affection—namely, appendicitis. The possibility of the inflammation of the cecum as a result of fecal accumulation is denied by Noth- nagel, Sahli, and Sonnenburg and Fowler (“Treatise on Appen- dicitis,” Philadelphia, 1894). But according to the observations of Porter, Curschmann, Manly, Deutschmann, and Kronlein, the occur- rence of primary typhlitis can not be doubted. Osier gives a chapter to the consideration of this disease, but admits (p. 405, “Practice of Medicine”) that its anatomical condition is unknown, and that it is by no means certain that these cases are really cecal. Priebram describes it (Ebstein u. Schwalbe, “Handb. d. prak. Med.,” Bd. 11, S. 688) similarly to Penzoldt (Penzoldt u. Stintzing, “Handb. der. spec. Therapie innere Krankheiten,” S. 486). Judging from a crit- ical review of the literature on the subject and from my personal experience and private practice, I do not think that we can discard the clinical conception of a simple primary typhlitis. As I have said before, I have seen ulcers of the cecum with circumscribed catarrhal inflammation, and even a limited peritonitis over the ce- cum, where the appendix was to all appearances normal. • Admit- ting the extreme rarity of such conditions, we can, however, not entirely deny the existence of such a disease of the cecum, indepen- dent of involvement of the appendix. Nature, Description, and Etiology. Simple catarrhal inflammation of the vermiform process and of the cecum, either each separately or both combined, is a more fre- quent disease than is usually supposed. In those cases in which the inflammation is confined to the mucosa and submucosa it may remain latent and take its course without any symptoms at all. At most it causes but vague disease symptoms, and can be recognized only when the increasing inflammation affects the peritoneum. This may be the principal reason why the frequent occurrence of catarrhal appendicitis and typhlitis is not generally admitted. There