APPENDICITIS. 



385 



Chronic inflammation may succeed the acute. In some cases 

 the inflammatory process is limited to the rectum proctitis. 

 Appendicitis inflammation of the vermiform appendix is 

 now recognized as the cause of the set of symptoms which 

 were at one time attributed to inflammation of the caecum 

 typhlitis. On laying open the appendix, faecal concretions 

 are sometimes found, to which an etiological significance has 

 been attributed (Figs. 173 and 174); but they are quite as 



FIG. 1 



Funnel-shaped csecum and appendix, gangrenous appendicitis : 1, fecal concre- 

 ment; 2, mesenteriolum ; 3, appendix, situated behind and to inner side of 

 caecum ; 4, ilio-csecal junction (Hartley). 



likely the result as the cause of the condition, and formed by 

 accumulations of mucus, desquamated epithelial cells and 

 other inflammatory products. Undoubtedly the common colon 

 bacillus, which is normally present, plays an important part, 

 multiplying rapidly and gaining new virulence in the favor- 

 able nidus produced by the inflammatory process. The entire 

 wall of the appendix may be involved, or the lining mucous 

 membrane alone. Necrosis and ulceration may result 



n 



25 Hist. 



