4 IMMUNITY IN HEALTH 



lymphatic structure of the vermiform appendix and 

 drew a comparison with the tonsil. Analogies between 

 the tonsils and the vermiform appendix have since been 

 noted by other observers. Ransohoff in 1890 pointed 

 out that both were liable to recurrent inflammatory 

 attacks ; Bland-Sutton added in 1891 that in each of 

 the structures the inflammatory attacks were particu- 

 larly comm6n in early life. Kelynack in 1893 observed 

 '* that the calculi frequently met with in the tonsils are, 

 as far as their inorganic constituents are concerned, 

 practically identical with concretions of the vermiform 

 appendix." Murchison in 1866 described ulceration of 

 the appendix as accompanying ulceration of Peyer's 

 patches in one case of typhoid fever, and many similar 

 cases have been related since. 



In 1890 Dr. Armand Ruffer showed the presence of 

 micro-organisms undergoing phagocytic destruction in 

 tonsils, Peyer's patches, and vermiform appendix in 

 various animals. (The penetration of Peyer's patches 

 by micro-organisms had been shown five years pre- 

 viously by Ribbert and Bizozzero.) 



As to their function, it has hardly ever been conceded 

 that the subepithelial glands are of net utility. Darwin 

 in 1874 wrote that the appendix was "useless." Treves 

 in 1885 spoke of "its very slight physiological import- 

 ance," and in 1890 had hardened himself to write it 

 down a^ "useless and functionless." Macewen in 1904 

 was almost the first to suggest that there might well 

 be a function. Keetley was sufficiently imbued with 

 the idea of a value for the appendix to propose his 

 operation of transplanting the appendix into the abdo- 

 minal wall instead of appendicectomy in certain cases, 

 and Edred Corner (1912) and Keith (1912) have each 

 written favourably of the activities of the appendix, 

 whilst Mackenzie (1912) has taken up the defence of the 

 tonsils. 



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