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Image from page 45 of "Lectures on appendicitis and notes on other subjects" (1897)

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Identifier: lecturesonappend1897morr
Title: Lectures on appendicitis and notes on other subjects
Year: 1897 (1890s)
Authors: Morris, Robert T. (Robert Tuttle), 1857-1945
Subjects: Appendicitis Surgery, Operative
Publisher: New York, G.P. Putnam's Sons
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
rgo marked hypertrophy. Insome cases in which the appendix hasdisappeared Avith the exception ofa fibrous string of connective^^ tissue, ill-defined muscularisand peritoneum, the sclerosednerves yet keep the patient more orless of an invalid, because they ex-ert an influence which inhibits theperistaltic movements of the colon,and predisposes to constipation, in-testinal fermentation, and generaldyspeptic symptoms. I supposedthat this influence was due to oldadhesions until I found that patientsin whom few adhesions existed wererelieved from their discomfort andrapidly gained in health and strengthFig. 15.—Single round slough, after the removal of sclerosed ap-pendix remains.Peritonitis is the most important complication of appendicitis,and one which formerly attracted our attention so closely thatthe appendix Avas often overlooked. The simplest form of peri-tonitis complicating appendicitis is limited to the peritoneum ofthe appendix and mesappendix. The irritating products of bac-

Text Appearing After Image:
Appendicitis. 27 teria at work within cause a reddening androughening of the serosa of the appendix andmesappendix. The latter contracts firmly, re-maining contracted and fixed by adhesions ifthe inflammatory process is severe enough tocause the formation of plastic peritoneal exudateson the layers of the mesappendix. When theleucocytes fail to limit the peritonitis to the regionof the appendix, by their anti-toxine, the peri-toneum over near-by structures throws out plasticexudate, and the appendix is entirely surroundedby adhesions which wall it in. This is a verypretty subterfuge on the part of Nature, and itprotects the patient unless bacteria have gainedtoo much headway. Nature is appreciative ofsuccess, however, and when the bacteria haveproven themselves to be very enterprising, shetransfers her interests from the patient to the finecolony of bacteria whose claims for vested inter-ests outweigh those of the patient. In such acase the protecting peritoneal exudate is liquefiedby

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Date: 2014-07-28 06:51:57

bookid:lecturesonappend1897morr bookyear:1897 bookdecade:1890 bookcentury:1800 bookauthor:Morris__Robert_T___Robert_Tuttle___1857_1945 booksubject:Appendicitis booksubject:Surgery__Operative bookpublisher:New_York__G_P__Putnam_s_Sons bookcontributor:Columbia_University_Libraries booksponsor:Open_Knowledge_Commons bookleafnumber:45 bookcollection:medicalheritagelibrary bookcollection:ColumbiaUniversityLibraries bookcollection:americana

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