Local Signs.—­Tenderness of the rectus muscle (to the right of the centre of the abdomen) and tenderness or pain on deep pressure.  The muscle may be so rigid that a satisfactory examination cannot be made.  Sometimes there is a hardness or swelling in the appendix region.  Tenderness, rigidity and actual pain on deep pressure; with the majority of cases, a lump or swelling in the region of the appendix.

[Illustration:  Vermiform Appendix.  When Affected by Inflamation and Gangrene Necessitating an Operation.]

[Illustration:  Vermiform Appendix.  Showing Different Types.]

[Digestive organs 117]

Recovery.—­Recovery is the rule.  It frequently returns.  General peritonitis may be caused by direct perforation of the appendix and death in appendicitis is usually due to peritonitis.

Surgeons have declared that sudden pain in the region of the appendix, with fever and localized tenderness, with or without a lump almost without exception means appendix disease.  Rest in bed, take measures to allay the pain; ice bag applied to the part is very effective.

Operation.—­Dr. Osler, of Oxford, England, says.—­“Operation is indicated in all cases of acute inflammatory trouble in this region, whether the lump is present or not, when the general symptoms are severe, and when by the third day the features of the case points to a progressive (condition) lesion.  An operation after an acute attack has disappeared is not fraught with much danger.”

Diet.—­All food should be withheld for a few days if possible.  Liquids, such as egg albumen, weak tea, thin broth, barley or rice water, or milk diluted with lime water may be given in small quantities if necessary.  When the acute symptoms have subsided, milk may be taken undiluted, and eggs may be added to the broth.  When the pain and fever have disappeared entirely, gruels made of rice or barley, soft-boiled egg, scraped beef, stewed chicken, toast, and crackers may be added to the list; still later, mashed potatoes and vegetables, finely divided and strained, may be allowed and, finally, when well, usual diet resumed.

Appendicitis, Mothers’ Remedies.—­Home Treatment Found Good for.—­“To allay the pain and stop the formation of pus in appendicitis it is recommended that a flannel cloth be saturated with hot water, wrung out, drop ten to fifteen drops of turpentine on it and apply to the affected parts as hot as the patient can bear.  Repeat until relief is obtained.  Then cover the bowels with a thin cotton cloth, upon which place another cloth wrung out of kerosene oil.  This sustains the relief and conduces to rest and eventual cure.  It is an essential part of the absorbent cure for appendicitis, and since its adoption doctors do not resort to a surgical operation half so often.”  The above is a standard remedy and will most always give relief.