APPENDICAL PERITONITIS: EXPERIMENTAL AND CLINICAL INVESTIGATIONS INTO THE CAUSES OF THE HIGH MORTALITY

The most effective means of reducing the high mortality of appendical peritonitis is the prevention of perforation of the acutely inflamed appendix by teaching the public the dangers of taking laxatives and delaying hospitalization in the presence of abdominal pain. These investigations have already been reported under the prophylactic aspect of the Philadelphia plan. The scientific aspect presented here includes experimental and clinical research to develop an improved management of patients suffering with spreading peritonitis and to provide continuous research toward further improvement. The dog has proved to be well adapted for experimental investigations because: Peritonitis similar to that observed complicating acute appendicitis in man can be induced in the dog by ligating the mesentery and the base of the appendix and administering castor oil immediately after operation. 1 Gross tissue reactions in the dog following the induction of gangrene of the appendix are similar to those observed in gangrenous