[The treatment referred to is to let the patient alone except giving food by rectum.]

“I have had an opportunity to observe a very large number of these patients under this form of treatment, and have operated upon many of them at various intervals after the acute attack through which they were treated in this manner, and have been able to demonstrate that the patient can recover, and practically always does recover, if this method of treatment is employed.  Of course, one occasionally encounters a patient suffering from appendicitis who is in a dying condition, and then neither this nor any other method is of any value.”

“I find that many authors advise rectal feeding under certain conditions, but I am certain that the exclusive rectal alimentation is of greater importance in the treatment of appendicitis than any other single method, but I am equally certain that it must be carried out thoroughly, because even a small amount of food or the administration of a cathartic may suffice to bring about a fatal issue.”

[Why feed!  There is no danger of starving!]

“I am also certain that many patients are enormously benefited by the use of gastric ravage for the purpose of removing a quantity of decomposing material, the absorption of which would certainly do a great amount of harm.  I am also certain that gastric lavage does permanent good only if no further food is placed into the stomach, which would result in further decomposition.”

[At the beginning of treatment—­the first visit—­wash the stomach and then feed no more.

Although some physicians boast that this is an age of preventive medicine, the following paragraph is about all that is devoted to this phase of the subject.  In one or two places people are cautioned not to eat too much and chew thoroughly, but what does this amount to?  How many people know how much to eat or how thoroughly to chew?  Very few physicians have a grasp of this subject.]

“It is true that recurrences can usually be prevented by careful attention to diet, by securing daily free evacuations of the bowels, by avoiding over-work and above all things by abstaining from eating too freely, especially of indigestible food when tired.  Notwithstanding these facts most patients will never be entirely well after recovering from an attack of appendicitis, and if this is the case I believe that the best treatment consists in the removal of the diseased appendix.”

“In conclusion I will say that the most important lesson my experience has taught me is the fact that more harm is done to the patient suffering from acute appendicitis by the administration of any kind of nourishment or cathartics by mouth than in any other way, and that more lives can be saved by prohibiting this and by removing any food which may be in the stomach at the beginning of the attack by gastric ravage than by all the other methods of medical and surgical treatment combined.”