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
I called the second day; the patient had slept some--he thought
about three hours of broken rest--feeling fairly comfortable; pulse
120, temperature 101 degree F. at 9:00 a.m.; 102 degree F. at 5:00
p. m. Third day: Temperature 100 degree F. at 9:00 a. m.; 101 degree
F. at 5:00 p. m.; one-third of the tympanites gone; slept six hours;
hungry and demanding food. I said, "No, you get no food until the
bowels move." The ice was taken off the bowels; hot cloths were
substituted.
The fourth day the temperature in the morning was 100 degree F.; in
the afternoon 101 degree F., pulse 100; slept well, hungry, bowel
distention reduced fifty per cent. I touched him very lightly and
found enough to confirm my diagnosis of typhlitic abscess; this was
the first time I had felt that I was justified in attempting to
confirm my suspicions, and even this examination could not be called
a palpation, for I put no weight upon the abdomen. The patient was
very dissatisfied because I would not allow him food. I said, "No.
you can't eat until your bowels move." "How soon will they move!"
he asked in an irritating and ungracious manner, to which I replied,
"Your God only knows, and He won't tell."
Fifth day about the same, a little better; very ugly because I would
not allow him food. He said: "I don't believe there is anything the
matter with me; you are holding me down."
Sixth day about the same, feeling fine, sleeping fine and _starving
to death. _He made himself so unpleasant by his clamoring for food
that I permitted his wife to give him a half dozen Tokay grapes. He
had scarcely swallowed the sixth when he had all the pain he wanted.
His wife came to my office in great excitement: "Doctor, please come
at once to see my husband; he is much worse, he is in agony with his
bowels." My answer was: "Go back and renew your hot applications to
the bowels and tell your husband I permitted him to eat the grapes
because he had been so unkind and ungrateful for the comfort that
had been given him; tell him that I knew the grapes would give him
pain and that the pain will not wear off entirely for twelve hours,
and that I will not see him before tomorrow morning."
I called as I agreed to do the next day, the seventh day since the
case came under my management, and the fourteenth day from the
beginning of the disease. The sick man was out of humor. To my
question, "Would you like something to eat!" he drawled, "Na-a-aw! I
never intend to eat any more; but I would like to know when my
bowels are going to move." Of course I could not tell him any more
than I had told him before, namely, that under such circumstances
they usually require from fourteen to twenty-eight days.
Public-domain text, read in full here on John Shaqi.
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