High Appendicitis Death Rate Due To Early Bad Management
( Originally Published 1936 )
First, everyone should know that appendicitis is a common disease. It is especially common in young people. In fact, it is, in the great majority of cases, a disease of the first 30 years of life.
Second, appendicitis is a dangerous disease. When the life insurance companies get worried about the death rate from a disease it is time to take some notice of their warnings. Because it is evident that they are interested, not for theoretical reasons, but on account of hard-headed business reasons—because they lose money from it. The insurance companies believe that the high death rate from appendicitis is unnecessary. They pointed out recently that from 18 to 20 thousand people in the United States die every year from this disease.
The high death rate from appendicitis is due largely, if not entirely, to the bad management of the case early in the disease by the patient himself or his family.
The first fault consists in minimizing the importance of a stomach ache. The most prominent symptom of acute appendicitis is pain in the abdomen. The pain is usually localized first in the region of the stomach and later over the entire abdomen, and only after some time is localized in the region of the appendix. People are, therefore, led to believe that when the pain is in the stomach or the general abdomen it is simply indigestion. They feel that only pain over the appendix should be appendicitis.
Every sudden stomach ache deserves respect. That is the first great lesson for everybody to learn in order to reduce the death rate from appendicitis. Treat a stomach ache as if it were serious until proved otherwise.
Acute appendicitis is usually accompanied by nausea and vomiting, and by fever, but to all these things there may be exceptions.
The one wrong thing to do in the presence of a stomach ache is to give a cathartic, a laxative, or a purge. This is the second great lesson for people to learn in order to reduce the death rate from appendicitis. It is done so commonly that it seems impossible to eradicate this ingrained habit.
The harm which a cathartic can do in appendicitis was pointed out in an article recently—that by causing peristalsis in the intestines, it will rupture an appendix full of pus and spread the pus over the abdomen, causing general peritonitis.
Druggists who treat people who wander into the drug store are badly to blame on this count. I have heard of only one druggist who gave such a patient paregoric; the remainder gave salts or castor oil. If druggists must indulge in this bad practice, at least let them learn to dispense paregoric instead of a cathartic for a stomach ache.
I conclude with an excerpt from a letter recently received: "I read a prescription in a doctor book of some pills that I could take that would cure appendicitis. I have taken one of these for two nights and they leave me with griping pains in the right side, where your appendix is supposed to be. The pills contain cascarin, aloin and padophyllium." All of these are cathartics of the very worst kind that could be taken for appendicitis. No better lesson could be found of the harm which such treatment can do.