About 1890 appendicitis began to attract the attention of those surgically ambitious.  The ovariotomy or celiotomy expert began to feel the sting of envy and jealousy aroused by those who were making history in the new surgical fad—­appendectomy—­and they got busy, and, as disease is not exempt from the economic law of “supply always equals demand,” the disease accommodatingly sprang up everywhere; it was no time before a surgeon who had not a hundred appendectomies to his credit was not respected by the rank and file, and an aspirant for entrance to the circle of the upper four hundred could not be initiated with a record of fewer than one thousand operations.

Thanks to the law of supply and demand the ovaries retired and gave women a much needed rest.  If they had continued to misbehave as they had been doing before the appendix got on the rampage, the demand for surgical work would have exceeded the supply of surgeons.  Diseases of all kinds are very accommodating; as soon as a successful rival is well introduced they retire without the least show of jealousy, showing that they are not strangers to the highest ethics, their associations to the contrary notwithstanding.

There are many well written articles on appendicitis, but I believe the monograph by A. J. Ochsner, M. D., is decidedly the best, and when I refer to the best professional ideas on etiology, pathology, symptomatology and treatment I have in mind the opinions set down by Ochsner, for he has taken more advanced grounds in the medical treatment of this disease than any other physician I know anything about in this or any other country.  If his “A Handbook on Appendicitis” brought out in 1902, had come out three years before, I should give him credit for being the first man on record to proscribe the taking of food in appendicitis, but as my first written advice on the subject was in the July, 1900, number of A Stuffed Club,* two years before his book, I shall give myself the credit for being the first physician to announce to the world the only correct plan of treating the disease and suggesting the probable cause which the intervening time has proven to be correct The only reason I have for making this announcement is that in all probability no one else will ever do so, and, as it is just and right that I should have the credit, I do myself the honor.  The general rule is that if a new method of treatment comes out, or a discovery of importance is made other than in the regular professional channels, it will either be ignored or adopted (cribbed is more expressive) and no credit given.  This is a small matter, and of no special consequence, yet it carries a meaning.

(Editor’s note:  “A Stuffed Club” was the newsletter or journal published by Dr. Tilden for many years.)

Previous to 1890 the most popular treatment was probably the giving of opium; although this was far from ideal, “it had the advantage of taking away the patient’s appetite, relieving pain, and putting the bowels to rest.”—­Ochsner.  If there were any way to prove it, we should find that next to surgery opium is still the most popular way of treating the disease.