APPENDICITIS
SIR,—Your medical correspondent, Miles Howard, asks what influences surgeons to operate for appendi- citis. The main reason is that any surgeon of ex- perience has seen a certain number of very unpleasant deaths from this condition and knows that the one essential factor in the outlook is the length of time that has elapsed between the first symptoms and the operation.
To illustrate : not long ago two children, aged two and three, were brought to my hospital in one month suffering from appendicitis, which had been treated conservatively (or in hospital slang 'sat on') for several days. One was lifted out of the am- bulance dead, the other died while the theatre was being got ready. If they had arrived some twelve hours earlier we would have had two operational deaths to spoil our statistics.
Incidentally, it is curious that during all the cen- turies people have been getting bellyache the general public has never noticed that those who are tender to touch often die, while those who are relieved by pressure survive.—Yours faithfully,
DENIS BROWNE
46 Harley Street, WI
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