The fact that the bowels do not move in from twelve to twenty-one days should not be looked upon as total obstruction.  What obstruction there is is due to fixation of the parts and is truly a physiological rest—­it is on the order of the fixation of an inflamed joint—­the joint appears to be anchylosed, but as soon as the pain is gone it becomes as movable as ever.

Again, if the case is really obstruction it will grow worse daily even if my plan of treatment—­absolute rest from everything—­is carried out to the letter.

There is not any danger of the abscess opening anywhere except into the bowels, for that is in the line of least resistance and, if it fails to do so, it is because it is badly managed.

CHAPTER IX

I have appendicitis; what shall I do to be saved? Don’t eat anything until well.  Use a stomach tube and wash out the stomach; then use a fountain syringe and wash out the bowels; take a hot bath as hot as can be borne, and stay in the tub until all the pain is gone, or as long as possible; then go to bed, put ice on the bowels and keep it on until the temperature is reduced to 101 degree F., then apply hot applications or poultices and continue the poulticing until the bowels move, and the bowels will not move until the abscess breaks.

Use an enema every night as a routine, and drink all the water desired, when there is no nausea.

Don’t manipulate the forming abscess, nor allow anyone else to do so.

If you are really in doubt about what you have, think over what I have written about strangulation or positive obstruction, and if you think you have it, send for the best physician you know and get his opinion of whether you have obstruction or not, but don’t allow him to burst an abscess with his manipulations!  For, my word for it, if he can’t weigh symptoms and tell whether or not you have complete obstruction without punching holes in you with his bimanual manipulation, neither would he be able to do so after examining you.

I do not say this because I like to make it hard for doctors, but I prefer staying the heavy hand of the doctor to keeping still and allowing him unwittingly to kill his patient.

First of all wash the stomach out with a siphon tube, then see to it that nothing but water goes into the stomach until the bowels move.

I put my cases on a complete fast, give no drugs, apply ice to the region of the appendix, keep the feet warm, and keep the patient in an atmosphere of hope and belief in his recovery, and a recovery always follows.  I prescribe an enema of warm water once or twice daily, getting all the water possible into the bowels.