APPENDICITIS.

Otaki Mail, Volume 26, 28 May 1919, Page 4

APPENDICITIS.

VIEWS OP DR. COLLINS. CHIPPED ENAMELWAEE A CAUSE. “A cause of appendicitis” is .the subject of an article by Dr. Collins in the current issue of .the “New Zealand Medical Journal.” “General Henderson, D.G.M.S. (says Dr. Collins) has authorised me to record certain facts as to one of appendicitis, which has come under my notice during the period of the war. On October 2nd, 1917, I was given medical charge over a camp containing from 250 to 2SO men. On making inquiries into-the nature of the most frequent diseases- which had affected the man from the commencement of the war, I found that there had been 19 cases of appendicitis in the camp, and t(n operation had had to be performed in each case. In order to ascertain, if possible, . the cause of this number of cases of this disease, I made a general inspection of the buildings, food, etc. In the kitchen I found the enamel pans .'very much chipped, portions of the enamel could easily be. detached by the nail, and also enamel grit could be wiped off the bottom of the pans with -the linger. The enamelware was discarded. About a fortnight /later another case of appendicitis developed, and on the contents of the appendix being microscopically examined enamel grit was found iu it. Another patient had suffered from chronic appendicitis for a long time, but I did not consider at that time that his symptom's were sufficiently serious to justify an operation nor had my predecessor.” Dr. Collins gave up medical charge of the camp on May Kith, .1918, and (his patient was operated upon on June 17th, HUS; but, “as far as I epn ascertain,” says the doctor, ‘‘no special examination of the appendix was made. (Since that date, there has

not been a single case of appendicitis in the camp.” . Dr. Collins remarks,.ns the result of his own experience, upon how easily cnamolwarc gets chipped, and attributes to this cause also a proportion off the frequent cases of indigestion in the camp. “The number of patients who suffered from indigestion,” lie states, “diminished after the enamelware had been discarded. I felt certain that this had been in certain cases the causes of the trouble, and it lias occurred to me that it might even bo in some instances the cause of originating more serious complaints in the intestinal tract. According to recent year books the deaths from appendicitis were in:— 1812 72; 1913, 91; 1911, 86; 1915, 91; 1916, 90. “In 1917 the deaths from appendicitis in the New Zealand hospitals were 67. only, out of 2235 cases dealt with, giving a percentage of 2.5. . .• . The above figures would make it appear that the number of cases of appendicitis in the Dominion was very large. Tlie only way to settle the question as to the number of cases due to this cause Would be to have the contents of every appendix which is removed examined, not only bacteriologicaily. but microscopically. .The number of' eases due to this cause may be fensum!]. Enamelware for culinary purposes was, as far as I can gather, first introduced during the middle of the 19th century, since when its use has slowly and gradually become general, and I think is almost safe to say that both appendicitis . and malignant disease of the digestive organs have become more frequent during that period.”