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Moments in Surgical History
September 1998

AppendicitisThe Quintessential American Surgical Disease

Arch Surg. 1998;133(9):1024. doi:10-1001/pubs.Arch Surg.-ISSN-0004-0010-133-9-ssh0998

If ever there was a single pathological condition that represented the quintessential American surgical disease, then appendicitis fills most available criteria. As evidenced in Oliver Prescott's (1762-1827) first American account of death from a perforated appendix (1815) to Wolcott Richard's 1838 description of "death from ulceration of the appendix vermiformis," appendiceal abscesses had forever been treated without surgical intervention. Not until George Lewis (1823-1863) authored the country's first major review on the disease process (1858), was the theoretical necessity for early incision of an appendiceal abscess even mentioned in the medical literature. This is not unexpected given the poor results that occurred whenever any surgical operation of the abdominal cavity was attempted. As surgery evolved the defining and treating of appendicitis closely mirrored scientific, economic, and sociologic changes in our health care delivery system. Thus, allowing this disease entity to be correctly labeled as the first American surgical disease.

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