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August 5, 1893

SUPPURATIVE APPENDICITIS.Read at the Meeting of the Missouri State Medical Association at Sedalia, Mo., May, 1893.

JAMA. 1893;XXI(6):201-204. doi:10.1001/jama.1893.02420580023001g

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The history of the cases of appendicitis given in this paper warrants me in making a few remarks upon its pathology and diagnosis. Until recently the anatomy of these parts was not fully understood. Mr. Trêves, in 1885 called attention to the fact that the caecum itself is entirely covered with peritoneum, which after enclosing it is reflected upon the posterior wall of the abdomen, being continuous with the ascending mesocolon where this fold exists. This organ lies quite free in the abdominal cavity, allowing it to enjoy various movements owing to its structure and attachments. Rokitansky describes these as three-fold; first, rotation upon its own axis; second, upon the mesentery as an axis; and third, upon other intestines as an axis. From these movements the location of the appendix will vary even in health, and especially is this true after the results of inflammation have taken place. A knowledge

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