_I have appendicitis; what shall I do to be saved? _Don't eat
anything until well. Use a stomach tube and wash out the stomach;
then use a fountain syringe and wash out the bowels; take a hot bath
as hot as can be borne, and stay in the tub until all the pain is
gone, or as long as possible; then go to bed, put ice on the bowels
and keep it on until the temperature is reduced to 101 degree F.,
then apply hot applications or poultices and continue the poulticing
until the bowels move, and the bowels will not move until the
abscess breaks.
Use an enema every night as a routine, and drink all the water
desired, when there is no nausea.
Don't manipulate the forming abscess, nor allow anyone else to do
so.
If you are really in doubt about what you have, think over what I
have written about strangulation or positive obstruction, and if you
think you have it, send for the best physician you know and get his
opinion of whether you have obstruction or not, but don't allow him
to burst an abscess with his manipulations! For, my word for it, if
he can't weigh symptoms and tell whether or not you have complete
obstruction without punching holes in you with his bimanual
manipulation, neither would he be able to do so after examining you.
I do not say this because I like to make it hard for doctors, but I
prefer staying the heavy hand of the doctor to keeping still and
allowing him unwittingly to kill his patient.
First of all wash the stomach out with a siphon tube, then see to it
that nothing but water goes into the stomach until the bowels move.
I put my cases on a complete fast, give no drugs, apply ice to the
region of the appendix, keep the feet warm, and keep the patient in
an atmosphere of hope and belief in his recovery, and a recovery
always follows. I prescribe an enema of warm water once or twice
daily, getting all the water possible into the bowels.
These patients are so comfortable after the second or third day that
it is hard to make them or their friends believe that they have
appendicitis People are so afraid that they will starve to death if
they have no food for a few days that they make haste to get put on
a killing treatment rather than run any risk. This fear is absurd
Physicians are largely to blame for this popular ear, for those who
do not feed by mouth still have the idea that their patients must
have nourishment, so they feed by rectum. This is also absurd. What
the patient needs is rest, and the more complete the rest the
quicker the recovery. Give the patient all the water he wants.
The bowels will move in fourteen to twenty eight days from the
beginning of the attack. Then the fast can be broken by giving a
glass of hot milk, which is to be chewed well, or given in the form
of junket; this is to be repeated three times a day for a week, or
give the milk twice a day and a plate of mutton broth for the third
meal. I do not give solid food because there is a large abscess
cavity opening into the bowels, and if solid food is given before it
has time to close, it is liable to find its way into this cavity,
thereby preventing healing, and bringing on a chronic condition that
will ultimately end in death. The less food taken for one week after
the discharge takes place, the better. Any rational individual
should see that withholding food is the proper treatment. Milk
should be thoroughly mixed with saliva or not taken at all. Remember
that if milk is not taken with great deliberation, and great care
given to _thoroughly insalivate each sip, then it amounts to the
same thing as eating solid food._
Milk is a solid food when taken into the stomach as a beverage or a
drink like water.
In appendicitis all nature cries out for rest, and if it is given 99
out of every 100 cases will get well and there will be no suffering
and no danger after the first seventy-two hours.
The ordinary physician sends for a surgeon, and if he is a victim of
the surgical mania the patient must be operated upon at once, for if
twelve or twenty-four hours are given, the conditions may clear up
and an operation will be unnecessary. The majority of surgeons feel
that they will forfeit their right to heaven if they do not cut at
once. The consequence is that there are many patients operated upon
who are as innocent of having the disease as the surgeon is innocent
of a knowledge of a better plan of treatment.
Of course, the surgeon declares that pus should be let out by
cutting into it, or it is liable to break into the peritoneal cavity
and cause death This is positively not the truth, for when an
abscess threatens, nature at once proceeds to throw a wall around in
order to avoid accidents. All around the point of prospective
abscesses, heavy walls of adhesions are built, and if nature is not
interfered with, the abscess will break into the gut, because it is
the point of least resistance, and it is also the point favored by
gravity. The surgeons when they operate in these cases work exactly
opposite to nature.
If these abscesses are allowed to open into the bowel and solid food
is kept away from the patient, full and uncomplicated recovery will
take place. If solid food is given too soon it is liable to find its
way into the abscess cavity and cause a blind fistula, which may
take on acute inflammation at any time. These cases then become
chronic and are called recurring appendicitis. It is sound surgery,
in dealing with abscesses, to find, if possible, the direction
nature is taking to evacuate pus and be guided by this suggestion in
evacuating a pus cavity.
In order to cure appendicitis you must remove the cause. Cutting off
the appendix, opening an abscess, withholding food till the acute
symptoms have passed; such treatment is not removing the cause.
Nothing short of changing the eating habits of the patient will
cure, so the surgeon who knows nothing about food and its
action--what part improper eating has to do with bringing on the
disease--will never be able to cure.
Operating for this disease will fall into disrepute in time, for
there are already cases recurring and the second and third operation
will be necessary among those who survived the first. There is not a
scintilla of logical reasoning in defense of the operation. Because
some get well after an operation is no proof that the operation was
necessary; fortunately for the operator there is no way to prove
that the case operated upon would have recovered without the
operation. If the case be not complicated by bungling treatment an
operation is uncalled for. If a case has been medicated and fed to
death--abused to the extent of causing a rupture into the peritoneal
cavity--surgery must be resorted to as the only hope.
If a case survive an operation the patient is no wiser than he was
before, and knows nothing about avoiding another attack, for let it
be said loud enough to be heard by all, and with no fear of
successful contradiction, that if every child at birth should have
the appendix removed there would not be one case less of
appendicitis than there is with the appendix intact. Of course,
technically there could be no appendicitis without an appendix, but
the cecum would become inflamed just as readily.
No amount of forcing drugs given by the mouth can induce a movement
from above the constriction, but a great amount of pain can be
produced by attempting to force a passage. No one comprehending the
true state of affairs would be foolhardy enough to try to force the
bowels to move. The reader can readily imagine the great pain and
danger liable to follow cathartic drugs, for they stimulate severe
peristaltic contractions. The contractions drive the contents of the
small intestine against the inflamed cut-off, but there it must
stop. If the parts have become softened, which they do by the
inflammation, there is danger of perforation and an escape of the
contents of the bowels into the peritoneal cavity, after which
diffuse peritonitis and death follow. Surgery can hardly hope to
save such patients; in fact they usually die; this is why the
surgeon recommends an early operation.
If all cases are to be so abused and if there were no better way to
treat them I also should say, operate at once as soon as the disease
is discovered; but I know from years of experience that there is a
better way to care for these patients.