Excerpt from The Medical Age, 1905, Vol. 23: A Semi-Monthly Journal of Medicine and Surgery
For practical purposes we may. Recognize (1) ordinary catarrhal scolecitis, similar in etiology and nature to general typhlitis or colitis. It is scarcely worth while to answer such extreme surgeons as deny the existence of catarrhal conditions of the appendix and czecum, as they adduce no proof that the mucous membrane of this particular region is immune to the general pathology of mucous membranes. An interstitial inﬂam mation or degeneration similar to that which occurs in-the sub mucous tissues elsewhere, and necessarily leading to stricture unless absolutely uniform in its progression. If the strictures are mild in' degree, this process is favorable as tending to atrophy. (3) Acute inﬂammations, essentially bacterial, which may be limited to the mucous membrane, with discharge of muco-pus into the intestine; which may produce phlegmonous inﬂammation of the appendix itself with discharge internally or into the peri toneum, or which may induce gangrene. While perforation may occur through a normal-or slightly inﬂamed appendix, by _the pressure of a calcareous mass, lumbricoid, etc., or by actual traumatism by a pin, sharp bristle, spicule of glass, etc., such an accident is no more preventable for the appendix than for the intestine generally, and medically speaking, septic inflammation is to be regarded as the cause of a perforation of the appendix. Gangrene may arise as the result of infarction - embolic or throm botic - or possibly angiospasm, as in the stomach, independently of acute inflammation, or the appendix may become stran'gulated in an adhesion, but usually gangrene is a sequela of inﬂammation of acute grade.
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