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J. H. Carstens, M.D.
JAMA. 1898;XXX(4):227. doi:10.1001/jama.1898.02440560055009.
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Detroit, Mich., Jan. 11, 1898.

To the Editor:  —In the January 8 issue of the Journal I found an article on appendicitis, by an old practitioner, opposing operation and advising conservative treatment.The article refutes itself, as the report of eight cases with five recoveries and three deaths, or a mortality of 37 5 per cent., is so terrible that if surgeons would report any such mortality, a hue and a cry would be raised which could be heard across the continent. I simply want to call attention to it for fear that the article might have been overlooked. It is the same old story. By conservative treatment a good many cases will recover, and about 15 per cent will die. This man's statistics are far worse.There may be surgeons who are ambitious and inexperienced and who consequently operate when a patient is convalescing and there is no need


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