t man should not have been subject to fatal disturbances
of this organ from the very earliest times. On the post-mortem table,
the appendix of the lowest savage is the same useless, shriveled, and
inflammable worm as that of the most highly civilized Aryan, though
perhaps an inch or so longer. Secondly, there is absolutely no adequate
proof that appendicitis is increasing in frequency among civilized
races. It is only about twenty-five years ago that it was first
definitely described, and barely fifteen that the profession began at
all generally to recognize it.

But all of us whose memory extends backward a quarter of a century can
clearly recall that, while we did not see any cases of "appendicitis,"
we saw dozens of cases of "acute enteritis," "idiopathic (self-caused)
peritonitis," "acute inflammation of the bowels," "acute obstruction of
the bowels," of which patients died both painfully and promptly, and
which we now know were really appendicitis.

In short, from a careful study of all the data, including the claims so
frequently made of freedom from appendicitis on the part of Oriental
races, colored races, less civilized tribes, vegetarians, and others, we
are tending toward the conclusion that the percentage of appendicitis in
a given community is simply the percentage of its recognition,--in other
words, of the intelligence and alertness, first of its physicians, and
then of its laity. As an illustration, my friend Dr. Bloodgood kindly
had the statistics of the surgical patients treated in the great Johns
Hopkins Hospital at Baltimore investigated for me, and found almost
precisely the same percentage of cases of appendicitis among colored
patients as among white patients.

The earlier impression, first among physicians and now in the laity,
that appendicitis is an almost invariably fatal disease, is not well
founded, and we now know that a large percentage of cases recover, at
least from the first attack; so that it is quite possible for from half
to two-thirds of the cases of appendicitis actually occurring in a given
community to escape recognition, unless promptly reported, carefully
examined, and accurately diagnosed. Thirdly, in spite of the remarkable
notoriety which the disease has attained, the general dread of its
occurrence,--which has been recently well expressed in a statement that
everybody either has had it, or expects to have it, or knows somebody
who has had it,--the actual percentage of occ