Appendicitis: The Etiology, Hygenic and Dietetic TreatmentTilden, J. H. (John Henry)
Science
Appendicitis: The Etiology, Hygenic and Dietetic Treatment
Tilden, J. H. (John Henry)
Appendicitis
"It does not matter whether the patient suffers from catarrhal
appendicitis, with or without a foreign body in the appendix, or
whether the appendix be gangrenous or perforated, he will almost
invariably recover if from the beginning of the disease absolutely
no food is given by mouth."
"Some years ago, before I had learned to appreciate the treatment
which I now describe, I frequently operated upon patients in just
this condition, [condition of patient described as having
temperature of 104 degree F., pulse 140, abdomen very much
distended, features pinched and patient delirious], as a last
resort, thinking that this gave them the only possible chance of
recovery. Since then I have learned that this case belonged to a
class which practically never recovered after an operation, if it is
done while the condition is that in which I found this patient, and
of which a very large majority recover if the treatment is followed
which I have described."
[The treatment referred to is to let the patient alone except giving
food by rectum.]
"I have had an opportunity to observe a very large number of these
patients under this form of treatment, and have operated upon many
of them at various intervals after the acute attack through which
they were treated in this manner, and have been able to demonstrate
that the patient can recover, and practically always does recover,
if this method of treatment is employed. Of course, one occasionally
encounters a patient suffering from appendicitis who is in a dying
condition, and then neither this nor any other method is of any
value."
"I find that many authors advise rectal feeding under certain
conditions, but I am certain that the exclusive rectal alimentation
is of greater importance in the treatment of appendicitis than any
other single method, but I am equally certain that it must be
carried out thoroughly, because even a small amount of food or the
administration of a cathartic may suffice to bring about a fatal
issue."
[Why feed! There is no danger of starving!]
"I am also certain that many patients are enormously benefited by
the use of gastric ravage for the purpose of removing a quantity of
decomposing material, the absorption of which would certainly do a
great amount of harm. I am also certain that gastric lavage does
permanent good only if no further food is placed into the stomach,
which would result in further decomposition."
[At the beginning of treatment--the first visit--wash the stomach
and then feed no more.
Although some physicians boast that this is an age of preventive
medicine, the following paragraph is about all that is devoted to
this phase of the subject. In one or two places people are cautioned
not to eat too much and chew thoroughly, but what does this amount
to? How many people know how much to eat or how thoroughly to chew?
Very few physicians have a grasp of this subject.]
Public-domain text, read in full here on John Shaqi.
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