768 



Whether such obliteration is physiological or pathological is 

 another question. Bierhofp (17), Fitz (16), and others would seem 

 to regard it as pathological and think that the condition points to a 

 previous catarrhal appendicitis. 



Personally, I look upon obliteration of the appendix as a physio- 

 logical process occurring in late, middle and old age. I have already 

 endeavoured to prove that the characteristic of the human appendix 

 is lymphoid tissue (18), a tissue known to undergo atrophy beyond 

 a certain stage of life, and I think it is beyond all question that 

 such tissue does atrophy in the appendix and thereby produces the 

 subsequent obliteration. Such a view certainly harmonises with the 

 views expressed by Ribbert in his able paper. I agree with Ribbert 

 that the process is probably one of physiological involution and that 

 total obliteration only occurs, or is at all events most frequent, be- 

 tween the ages of 60 and 70 years. 



Bibliography. 

 (The numbers are those referred to in the text.) 



1) Clado, Appendix caecal: anatomie, embryologie, anatomie compar^e, 

 bactöiiologie normale et pathologique. Compt. Rend. Soc. de Biol., 

 9. April 1892, p. 133. 



2) ßiBBEBT, Beiträge zur normalen und pathologischen Anatomie des 

 Wurmfortsatzes. Virchow's Archiv, 1893, p. 66. 



3) Steuthees, On Varieties of the Appendix Vermiformis, Caecum and 

 Ileo-colic Valve in Man. Edin. Med. Journ., Oct. 1893. 



4) Keltnack, The Pathology of the Vermiform Appendix, 1893. 



5) FowLEE, Observations upon Appendicitis. Annals of Surgery, Part 

 13, Jan. 1894, p. 6. 



6) Bbyant, The Relations of the gross Anatomy of the Vermiform appendix 

 to some Features of the Clinical History of Appendicitis. Annals of 

 Surgery, XVII, 1893, p. 164. 



7) Smith, The Appendix Vermiformis: its Functions, Pathology, and 

 Treatment. Journ. Amer. Med. Assoc, 1888, X, p. 77. 



8) Ransohoff, Considerations on the Anatomy, Physiology and Phatho- 

 logy of the Caecum and Appendix. Journ. Amer. Med. Assoc, 1888, 

 XI, p. 40. 



9) Teeves, Hunterian Lectures. The Anatomy of the Intestinal Canal 

 and Peritoneum in Man, 1885. 



10) Feegusson, Some important Points regarding the Vermiform Appendix. 

 Internat. Journ. Med. Sei., Vol. 1, 1891, p. 61. 



11) FiNNELL, The Significance of the calcareous Concretions in the Vermi- 

 form Appendix. Med. Rec, 1869, IV, p. 66. 



12) Geelach, Zeitsch. f. rat. Med., 1847, VI, p. 12. 



13) Talamon, Appendicitis and Perityphlitis. Translated from the French 

 by EiCHABD J. A. Bebet M. B. C. M., 1893. 



