1923/05/19 by NELSON AMOS LUDINGTON, Nelson Amos Ludington
Medicine · #Appendicitis Diagnosis and Management #Intraperitoneal and Appendiceal Malignancies
paper · doi:10.1001/jama.1923.02640470026011
The comparatively infrequent, but obvious, association of acute appendical attacks with some form of strain or injury immediately preceding the attack has forced on clinicians the question of there being a true relationship of cause and effect present in this repeatedly observed sequence of events. The question has two parts: one having to do with the initiating of an original inflammation in a previously healthy appendix, and the other, with the establishing of an acute exacerbation of a previously existing inflammation. Concerning the first part of the question there is a unanimity of authoritative opinion to the effect that trauma does not initiate an original inflammation in the healthy appendix; concerning the last part of the question there is a great diversity of opinion. Two factors appear to be responsible, in large measure, for this situation. The first factor is the oft repeated dogma of the textbooks that the appendix