18, 6 Garcia and Solloza: Vermiform Appendix 713 
Cunningham(5) and Berry(1) attempt to classify appendicial 
positions into: 
The pelvic position. 
The retrocecal position. 
The inward position (pointing toward spleen). 
Variable. 
They lay special emphasis upon the futility of assigning any 
percentage of frequency to any one of the positions, but believe 
that they occur in the order given. 
Giannelli,(11) in his topographic study of the vermiform ap- 
pendix in fifty cadavers, classified them as follows: 
Per cent. 
Retroileal 36.3 
Retroileal-mesenteric 31.5 
Retrocecal 22.7 
Pelvic 9.0 
Regarding direction he reports: 
Retroileal and pelvic, the appendix is rectilinear. 
Retroileal and retroileal-mesenteric, it either forms an ansa or a figure 
of 8. 
Piersol(21) claims that, in the majority of cases, the appendix 
is wholly behind the cecum, either below or mesial to it. 
Ferguson,(7) in a record of one hundred twenty-three cases of 
presumably normal appendix, found the organ hanging down- 
ward in eleven cases; placed mesially in eighteen; on the right of 
the czecum in nineteen; and behind it in seventy-five. 
Miiller(19) says that of all the various positions of the ap- 
pendix, the “positive sub coecal” is the most commonly found. 
Waldeyer (37) regards the pelvic position, or that in which the 
appendix overhangs the brim of the pelvis crossing the iliopsoas 
muscle and common iliac vessels, as the normal and most common 
position. Nowicki(20) agrees with him and claims to have found 
it in one hundred éighty-nine cases out of a series of four hun- 
dred twenty. He believes the downward and the lateral posi- 
tions to be rare, being present in only seventeen cases of his 
series. In forty-five he found the appendix to be retrocecal; in 
forty-eight directed upward (forty upward and medially and 
eight upward and laterally) ; in fifty-eight (forty men and eight- 
een women) the appendix was parallel to the ileum up to the 
ileoceecal junction, in which position Jawroski and Lapinski(13) 
believed that it was palpable in 51 per cent of the eight hundred 
cases which they studied. 
