The Surgery of the Diseases of the Appendix Vermiformis And Their Complications

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, Feb. S, 1902, B?
SURGERY OF THE APPENDIX surgeon would be wrong to wait for the evidence of fluctuation before deciding that an abscess is present. It must be re- membered that rupture of an abscess in consequence of too much handling is not unknown.
The use of an exploring needle has been advocated, but British surgeons agree with Sir Frederick Treves in his condem- nation of its use ; it is dangerous and unreliable in this disease as in other abdominal conditions when used as an aid to diag
...- nosis. It is much more satisfactory to administer an anaes- thetic and examine the patient when he is under its influence. A little gas and oxygen will usually suffice. In all cases the rectum should be examined with the finger.
If the iliac swelling persists and there is hectic fever, although fluctuation cannot be made out, pus is assuredly present.
Again, when a case of iliac phlegmon has developed an unusual rise of temperature, in an otherwise normal course, suppuration should be suspected, or a fresh attack of appendix inflammation.


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