Appendicitis : its pathology and surgery . to fail. The face wasless blue and the expression better. The pain had ceased. Aliquid motion and much flatus had followed a dose of pulse afterwards rose to 132, and the temperature to 102° quantity of foul discharge was washed from the tube. Therewas increasing frequency and feebleness of the pulse, and shedied about thirty-six hours after the operation. A portion of the concretion was made into a cover-glass 78 APPENDICITIS preparation and stained. A section would, perhaps, have beenmore instructive, but as yet we have failed to obt
Appendicitis : its pathology and surgery . to fail. The face wasless blue and the expression better. The pain had ceased. Aliquid motion and much flatus had followed a dose of pulse afterwards rose to 132, and the temperature to 102° quantity of foul discharge was washed from the tube. Therewas increasing frequency and feebleness of the pulse, and shedied about thirty-six hours after the operation. A portion of the concretion was made into a cover-glass 78 APPENDICITIS preparation and stained. A section would, perhaps, have beenmore instructive, but as yet we have failed to obtain one. The microphotograph (Fig. 19) shows that a smear from afascal concretion is composed almost entirely of a mass of comprise bacilli of the most varied types. Amongst themare long and slender, short and thick, small and ovoid, big andspore-bearing varieties, and so forth. The bacilli are single,in pairs, or short leptothrix. In addition many cocci, diplo-cocci, and short chains of cocci are present. The preparation. Fig. 20.—The wall of an acutely inflamed perforated appendix which containedconcretion. x 1000. also shows that the concretion contains yeasts and probablymoulds. The usual vegetable fibres and crystalloid bodies arepresent in small quantities, but are not seen in the micro-photograph. In truth, the concretion is simply an inspissatedmass of bacteria. The appendicular wall in the neighbourhood of the per-foration is so altered by acute septic inflammation, that hardlyany trace of muscular coats, and none of glands or epithelium,can be discovered. Amidst the purulent infiltration are vastnumbers of bacteria (see Fig. 20). vii FAICAL CONCRETIONS 79 In some parts, hardly any but micrococci can be are single, in pairs, in short chains of three or four, orin little groups. In other parts, the cocci are mixed withbacilli, amongst which are small ovoid bacilli, often in pairs,rather slender bacilli, about the size and shape of tubercleba
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