ACHIEVEMENTS OF SURGERY 435 



cessful operations for abscesses in the right iUac fossa arising 

 from the appendix, the earUest of which was performed in 

 1847. In one of these cases the abdomen was opened before 

 fluctuation was detected. 



In 1886 Reginald Fitz, of Boston, a medical man, cleared 

 up the entire subject of tj^hlitis and perityphlitis and called 

 the disease for the first time appendicitis. He gave the in- 

 dications for treatment and turned the disease over for the 

 consideration of surgeons. He fought hard for early surgical 

 interference in this disease and holds that surgeons are justified 

 in operating before the third day. 



Thomas G. Morton, of Philadelphia, was the first to operate 

 successfully for the removal of the appendix after making a 

 diagnosis of disease in this organ. (April 27, 1887, and pub- 

 lished in the same year.) 



Treves, of England, in 1888, suggested the first improve- 

 ment in the technique of excision of the appendix or appen- 

 dicectomy, which was followed in the same year by an able 

 paper on this subject by Nicholas Senn, of Milwaukee. 



C. McBurney, of New York, in 1889, pubhshed an article 

 on appendicitis which is considered a classic in the surgical 

 history of America. He first described and accurately located 

 the point of greatest sensitiveness to pressure in this disease, 

 which point has since been known as McBumey's point. The 

 abdomen was now being opened under the most rigid anti- 

 septic precautions, and appendicectomy was now becoming 

 recognized as the only rational treatment of appendicitis. 

 McBurney, to combat the old idea of waiting for an abscess to 

 arise, or to wait because the symptoms were not sufficiently 

 urgent, etc., closes his paper with the following words: 



"I hope that I may never again go every day to visit a 

 threatening case, waiting bashfully for the authority of a clearly 

 defined peritonitis before I dare take action. ... If it can be 

 shown by future experience with improved methods of oper- 

 ation, and with more perfect antiseptic precautions, that the 

 exploratory incision for inspection of the diseased appendix 

 is much more free from danger than the expectant treatment, 

 then there could be but one answer to the question: What 

 is the best treatment?' ' 



