Appendicitis or Censure.
I recently had another experience in treating a case of appendicitis that was not appendicitis, and in snatching the patient, a young lady, just about to be married, at the last moment, from the operating table, and from what would have been almost certain death. There was a violent inflammation in the descending colon; nearly all the pain and tenderness was on the left side. There was some diffused tenderness across the epigastric region, which passed down the upper portion of the ascending colon; there were slight colicky pains at McBurney's point. There was no enlargement or hardness in that locality. Almost no tenderness, and no rigidity of the rectus muscle.
Two young surgeons, both members of the faculties of prominent colleges in Chicago, had declared that rupture of the appendix was imminent, and that the only salvation was immediate operation. I actually pitied these two young surgeons, so strong is the sentiment of the surgical portion of the profession; so strong that they did not dare to face any other diagnosis but that of appendicitis. If the results of other treatment were bad, forty-nine surgeons out of fifty would have heralded their ignorance and declared that they were criminally negligent. They seem to have no alternative in case of an inflammation within the abdomen, but to declare it appendicitis.
It is certainly a most pitiable condition of things, that nearly every abdominal inflammation nowadays, must be operated upon or the surgeon is condemned. There are but few surgeons that dare face the censure, that would be heaped upon them in case of failure. Furthermore, there is but little medical treatment laid down in the books for these cases, hence the young doctor has no recourse.
This patient was treated with hot applications, bryonia, echinacea, and enemas of hot sweet oil, and was deprived of food for three days. The result of the treatment was strikingly satisfactory. Happier results in no case could have been obtained.
Another feature of these cases was sprung upon me in this case, although it was settled satisfactory. While the patient and friends were very grateful that they were saved from the dangers and subsequent inconveniences of an operation, and were also saved an expense of three hundred dollars for surgeon and hospital fees, it took them quite a little time to be satisfied that it was not a good deal of a hardship to be obliged to pay an attending doctor, one hundred dollars for medical fees for less than a week's attendance.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.