The vermiform appendix and its diseases / by Howard A. Kelly ... and E. Hurdon ... With 399 original illustrations, some in colors, and 3 lithographic plates.

  • Kelly, Howard A. (Howard Atwood), 1858-1943.
Date:
[1905], [©1905]
Catalogue details

Licence: In copyright

Credit: The vermiform appendix and its diseases / by Howard A. Kelly ... and E. Hurdon ... With 399 original illustrations, some in colors, and 3 lithographic plates. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    860/898 (page 796)
    The second case, which I wish to contrast with this one, occurred in Baltimore twenty years later, and was reported in one of the daily papers (Baltimore Daily Sun, July 28 and 29, 1902). A boy, twelve years old, died at St. Joseph s Hospital, after an operation for appendicitis, immediately following a blow upon the abdomen, struck by a companion, during a quarrel. The assailant was ar- rested on the charge of assault, and then released, but on the death of the patient he was re-arrested to await the verdict of the coroner's jury. The city physician, N. G. Keirle, testified that the autopsy showed mflammation of the appendix which had given rise to appendicitis. The appendicitis could have been occasioned by a blow. There was no foreign body in the appendix. The verdict of the cor- oner's jury was: We find that death was caused b}^ appendicitis and peritonitis, but we are unable to say in what manner said appendicitis was caused.'' The prisoner was, therefore, released. It will be seen that in the twenty years be- tween my first experience and this case, professional opinion had so far advanced that the possibility of a traumatic origin for the appendicitis was readily admitted, although not considered sufficiently established to justify an unfav- orable verdict. It is but natural that only the most positive proof should influence a jury to find the defendant guilty under such circumstances. W. B. Small, of Lewiston, Maine, writing upon the relation of trauma to appendicitis (A^ Y. Med. Rec, 1898, vol. 54, 364), says: I believe the true cause of the greater percentage of appendicitis in young men is found in the more frequent exposure to accidental injuries and strains, and to the strong contrac- tions of the abdominal muscles necessary in their work This ex- planation brings the subject into prominence from a medico-legal point of view. Some cases show plainly the direct results of external violence, and I belie^'e accident insurance companies or corporations, and individuals responsible for the occurrence of accidents, are as plainly liable as for a broken limb. This opinion accords with my own. Small, six years ago, was able to collect 15 cases of appendicitis occasioned b}^ trauma, from the literature and from individual reports; now, six years later, I find 50 with but little effort. I present these as illustrative without comment, in the form of brief abstracts, with the original reference in every instance. 1. GoLDBECK. I. D. Wurms, 1830. A boy, ten years old, fell from the top of a hay-wagon, and eight days later began to have pain in the right ihac fossa, with the usual symptoms of appendicitis, increasing in severity until death. At the autopsy the appendix was found gangrenous and perforated; its tip contained a fecal concretion. 2. G. SouTHAM. Lancet, 1840, vol. 2, p. 565. A man, twenty years old, a weaver by trade, received a severe blow from his beam, which smmg round and struck him in the abdomen. Slight pain, generally distributed over the abdomen, began shortly after the injury was received, and persisted for six months, although it was not severe enough to prevent the patient's Avorking for some time; at the end of half a year, however, it increased in severity and became localized in the right