CHANGES IN THE BLOOD AND THE COMPOSITION OF THE PERITONEAL EXUDATE IN INDUCED SPREADING PERITONITIS: A PRELIMINARY REPORT

Death from appendicitis-peritonitis is one of the major problems of medicine and surgery today, and the condition ranks ninth among the principal causes of death. Appendicitis-peritonitis is the cause of over 92 per cent of so-called deaths from appendicitis, and the mortality rate throughout the United States is approximately 33 per cent. The results of a workable proved plan for reduction of the mortality rate have been published elsewhere. 1 A study of appendicitis-peritonitis induced in the dog, investigations of blood and other body fluids in our own patients and a study of the reaction of 10,306 patients to appendicitis-peritonitis (26 per cent of 39,087 patients with acute appendicitis admitted to 181 hospitals in Pennsylvania over a period of ten years) together indicate that several factors, namely, leukocytosis, the cementing together of loops of intestine by plastic exudate, the migration of the omentum and the presence or absence of antibodies,