By Dr. Matteg, Ravensburg.

As is well-known, the appendix vermicularis, with the herbivora, is enormously extended and we find in it a quantity of undigested food, while further up in the larger intestine the food has already disappeared. Why then should man, who eats everything, also herbs, have no vermiform appendix? Cellulose and fibrin are not digested by the saliva, the gastric juice or the intestinal and pancreatic secretions, while in the vermiform appendix it is transformed into sugar and into carburetted hydrogen gases (see “The function of the Caecum and of the verimiform appendix,” by Dr. Schlegel, Allg. Hom. Z., 1095, Nr., 7 and 8).

     My supposition is that the supposedly superfluous vermiform appendix is, as it were, the rudder and the lever of the peristaltic action of the caecum and of the large intestine, and also he regulator for the Bauhinic valve, extending, when it is opened and contracting when it is closed, and then discharging its digestive juice. Therefore, when the vermiform appendix is diseased, this action ceases, and there is a paralysis of the large intestine and of the ileum, and constipation with frequently following intussusception or volvulus. This is another reason for supposing that the so-called typhlitis stercoralis is a secondary phenomenon, i. e., a consequence of a disease of the vermiform appendix, fomented by internal causes ( as indicated above), and so also the disturbance in digestion after the extirpation of the vermiform appendix may thence be explained.

     It is probable that through immoderate use of meat, and the use of meats not always sound, which, in consequence of the modern mode of feeding the stock, are continually becoming more common, the lymphatic juices and also the lymph of the vermiform appendix are becoming much corrupted (by the so-called nuclein albumen), since, as is well-known, infectious bacilli are more easily formed from a meat diet than from a vegetable diet. Now, in this one-sided, i.e., predominantly meat diet, the strong and, besides this, also corrupted secretion of the vermiform appendix finds no use and no disposal, and through further decomposition there may be formed inflammations and congestion’s in the lymphatic passages.

     If, then, exceptionally, or at rare intervals, fibrous food is consumed, as happens at certain seasons of the year, it will frequently lie undigested, and will then, of course, also further contribute to foment the inflammation already existing. As is well known, an organ which does not find the appropriate activity frequently becomes diseased and it degenerates.

     Therefore, give the caecum its appropriate activity and do not live in a one-sided manner on meat, but also, and, indeed, predominantly, on a vegetable diet and on vegetable fibre! This is the best way of guarding against appendicitis! In regions where people live more than they do with us on vegetables, this disease is found more rarely, while in regions with prevailing meat diet it is as frequent as tuberculosis, as, indeed, it is the frequent precursor of the same. For whoever has once passed through appendicitis is, and remains, according to my experience, predisposed to tuberculosis, and then also it is only appendicitis. Thence it is necessary that a physician, during appendicitis and afterwards, should treat the whole man, i. e., he should improve his constitution, and not cut out the vermiform appendix in order to guard against this disease. The best protection is a natural mode of life, with a predominant vegetarian diet and temperance, or rather, abstinence from alcohol, a proceeding which is also to be recommended in the tuberculous diseases of the various organs, which diseases follow after appendicitis:

      After an operation on the appendix, the digestion of vegetable food is essentially limited from the causes above indicated, and, according to my experience, there frequently appear disturbances in digestion, diarrhoea or constipation, with flatulence. On the other side, man, through a one-sided meat diet, becomes more prone to various diseases, especially to cancer and tuberculosis. And especially those of a tuberculous disposition, who have been operated on after typhlitis, thereby become particularly prepared for tuberculosis, and especially to abdominal and intestinal tuberculosis. I have been able to show with certainty that people, who, in the course of years, have been seized with appendicitis, are tuberculous or descended from tuberculous families. It is also certain that the particular age and constitution which dispose to tuberculosis of the lungs are also easily seized with appendicitis.

     Appendicitis is as certainly an introduction to tuberculosis of the lungs as the lymphatic swelling of the glands of the various organs. My treatment is predominantly a constitutional one; therefore, besides the various well-known medicines, Tuberculinum plays the first role and in all the cases treated by me in the last ten years; it produces a decisive and rapid improvement and cure, without passing into suppuration. The cases treated by me in that time were sixty, and of these I only lost two, these being advanced cases in which perforation ensumed in the first five or six days. From this surprisingly rapid action of Tuberculinum we may also again conclude as to the tuberculous nature of typhlitis.