SIGNIFICANCE OF THE OBSTRUCTIVE FACTOR IN THE GENESIS OF ACUTE APPENDICITIS

Abstract
The significant rôle of the vermiform appendix in the causation of perityphilitic suppuration was established by Fitz,1 of Boston, in 1886. This was almost fifty years ago, and in the intervening years, thanks to the fruitful labors of Pasteur and Lister, surgery has broadened in its scope from a science concerned primarily with the dressing of wounds to one holding an important position in the treatment of disease. Knowledge concerning the recognition of the clinical picture of appendicitis and the surgical technicalities involved in its removal have grown apace, but information concerning the nature of the origin of appendicitis remains almost as obscure as when Fitz made his prophetic pronouncement. Appendicitis continues to prove fatal, and if one considers actuarial tabulations, the mortality is increasing. In the last twenty-five years2 there has been an increase of 30 per cent. Whether this is apparent or real is not yet