Various reports have implied that there is a decreasing incidence of appendicitis. Palumbo1 reported a series of 1,600 cases of acute appendicitis from 1947 to 1958. The number seen in 1948 was 252, and only 45 in 1958. There is incomplete evidence, at the present, as to whether this is in reality a fact or only a supposition. During the era from 1939 to 1957, the mortality has shown a steady decline from 9.9 to 1.2 per 100,000.2
The usually subscribed causes for such an improvement may again be enumerated: increasing awareness of the disease on the part of the public, a better understanding of its natural course, and proper preoperative preparation of the patient, with fluids, electrolytes, blood, and antibiotics. Early operative intervention permits the removal of the diseased organ at a time which should result in the least harmful sequela. However, too many are not being