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September 27, 1924


JAMA. 1924;83(13):961-963. doi:10.1001/jama.1924.02660130001001

Nearly every one who has written on appendicitis in children has emphasized certain features: the obscurity of the symptoms; the rapidity of the progress of the disease; the great tendency to the development of peritonitis, especially general peritonitis, and, in younger children particularly, the high mortality. From the figures of Manley, McCosh and Churchman, it is readily apparent that appendicitis in children under 5 is distinctly uncommon, and in those under 2 years it is really a rare disease. Many a physician may go years without seeing, perhaps may never see, appendicitis in the very young. All the features that characterize the appendicitis of childhood have their influence on its medical aspects, and these are almost entirely connected with the question of diagnosis. While I shall deal chiefly with diagnosis and leave to the surgeons the entire question of treatment, there is one aspect of appendicitis that I should like