"THE CHALLENGE OF APPENDICITIS"

A "challenge" is what Reginald Fitz¹ calls appendicitis. His father² in 1886 first emphasized in this country the importance of early removal of the inflamed appendix in order to lower the mortality which follows perforation with its resultant peritonitis. In the more than fifty years that has elapsed, the teachings of the earlier Fitz have been abundantly verified and confirmed by countless clinical observations. The way seemed clear to remove the inflamed appendix from our mortality records as a common cause of death, particularly since, with the development of modern surgery, appendectomy in itself is associated with a mortality which is practically nil. Still true today as it was fifty years ago, however, the deaths which occur from acute appendicitis are found only in those patients who have developed a peritonitis from perforation.

The mortality from acute appendicitis has risen sharply during the past few decades. This constitutes