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January 5, 1901


Author Affiliations


JAMA. 1901;XXXVI(1):27-30. doi:10.1001/jama.1901.52470010027001f

"Walled off" is an expression so often heard in connection with cases of appendicitis which have gone on to pus formation, that I have selected it for the subject of dicsussion. When I hear a physician boast that his case has advanced to this stage and is ripe for operation, I often wonder how it is possible for him to have been unaware of the dangers to which the patient has been subjected and feel sorry for the physician's or surgeon's lack of knowledge of the living pathology of this vicious and deceptive disease that he has allowed to stealthily advance to that point where he believes he has every reason to congratulate himself. The most charitable view one can come to is, that he is familiar with operation under this one circumstance only.

In order to make clear the object of this paper, let me draw the comparison between

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