OBSTRUCTION AND CONSEQUENT DETENTION THE CAUSE OF APPENDICITISAS PROVED BY CASES AND BY EXPERIMENTAL APPENDICITIS IN DOGS.

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Abstract
We frequently find an obstructed and overdistended appendix, and the earlier in the attack the appendix is seen the more frequently is this condition observed. It is constantly mentioned by writers, and is by several connected with the production of gangrene, notably by Hartley,1Ochsner2and Hemmeter.3Robert Abbe4has made mention of this condition in connection with his study of stricture and recurring appendicitis. Dieulafoy5has said much about his theory of a closed sack and its effect in increasing the virulence of bacteria. I fail to find, however, any reference to the resulting hydraulic pressure on the blood vessels of the mucosa and submucosa and the consequent blood stasis in the inner layers of the entire wall of the distended sack. This is to me the important missing link between constriction and infection, and the point toward which this paper is principally directed. The appendix has a firm

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