What was appendicitis like in 1915?

I’m writing a novel that is set in 1915 England in which one of the major characters, an otherwise healthy 15-year-old girl gets appendicitis. Unfortunately I am having trouble with my research. I have a background in the medical field and have had an appendectomy myself, but I have no idea what such a condition was like back then when medicine and surgery were still taking their baby steps.

I’ve tried googling things like “appendectomy history”, “appendectomies in 1915”, to no avail. The things I need to know are:

-how was appendicitis diagnosed?

-what was the treatment of choice for mild appendicitis vs perforated appendicitis?

-what was the survival rate for surgical intervention in mild vs perforated cases?

-how large was the incision and where was it located?

-what type of anesthesia was used for pre-med, induction, and maintenance?

-what was waking up from that type of anesthesia like, in terms of mental clarity, confusion, paralysis, etc?

-were patients intubated or did this not come until later?

-did patients receive IV catheters or did this not come until later? If so, did they receive fluids during surgery?

-what was given as post-op pain meds?

-how well did doctors suture back then?

-how well were sterile fields and instruments maintained?

-was skin shaved and aseptically prepped prior to surgery?

-was there an anesthetist whose primary job was to induce the patient, maintain the patient, monitor vital signs, provide pain meds as needed, and recover the patient, or was it pretty much just a surgeon flying by the seat of his pants?

-what parameters were assessed to ensure the patient was doing fine under anesthesia? Did they check heart rate, blood pressure, temperature, respiratory rate, jaw tone, eye position, muscle relaxation, etc?

Anybody know where I can find this info?

Thank you so much!

Until very recent years, a rectal exam was part of an appendicitis diagnosis, and may still be. Ether anesthesia would have been used, and there’s also a very good chance that the appendix burst, or nearly did, by the time the surgeon operated. Phenol and Lysol were the most common antiseptics, and the latter was even used to wash out abscesses (very diluted, BTW). It’s doubtful that the patient would have been intubated, and chances are, the incision was quite large.

Beyond that, I’ll let a physician give more details.

I do not have access to the whole article but it looks like this one might be a good place to start.

If you could find a copy of this it would give you what you want too I think.

And this book on line written at the time by one of the pioneers of the procedure will definitely be useful to your research, as will this article.

Endotracheal intubation for anesthesia was first done in 1909 … unlcear how fast its use spread and if an appendectomy 6 years later would have used one.

Hope that helps a little bit and good luck!

I believe the anesthesia was give the patient a piece of wood they can bite on

Not by 1915. :rolleyes:

Choroform or ether would be the likeliest choices.

Edward VII had an appendectomy in 1902 which delayed his coronation. You can read about it here: http://www.appendicitis.pro/the-reginald-fitz-memorial/the-appendicitis-of-king.html (you have to scroll pretty far down to get to the actual description of the operation). He was given Ether as an anesthetic.

The http://www.appendicitis.pro site also looks like it’s got the sort of historical information you’re looking for.

FWIW - my own anecdote. I came very close to having my appendix burst when I was 10, in the early 70s. The two symptoms I remember is a few days before I had a profound sense that my abdomen was going explode. Not that I was going to puke, but that I was just going to burst. Imagine the worst bloating it would be possible to have. The morning of the operation, and what got me taken to the ER, was an extremely painful lower back. Anyway, the doctor diagnosed the problem following that and went in to cut it out. (Small town; doctor and surgeon were the same guy.). Apparently, it was very close to popping! So if you wanted some symptoms, there you go!

Symptoms of appendicitis vary considerably and are easily confused with other problems. In any era, including today, it’s difficult to definitively diagnose. So you can use any convenient description of its symptoms, and any diagnostic steps not dependent on technology that didn’t exist yet.

This isn’t what you asked for, but I had my appendix out in 1950, I was 13. Diagnosis was by pain, palpation, and a blood count. No rectal exam. It was done with a spinal anesthetic (scared me half to death because I was wide awake and numb from the waist down). If they gave me anything for pain after, I don’t recall. They did give me a one week course of an antibiotic. Th incision is about 2 inches long (there are two other smaller incisions because the surgeon saw a couple of moles in nearly the same place he didn’t like the look of and took them off too). There were no tubes and I don’t recall any recovery problems. I spent one week in the hospital (which charged an amazing $8 a day, paid by Blue Cross) and one week at home before returning to school.

My father told me about his older brother having his appendix burst in 1930s. They operated and essentially took everything out they could and just washed and scrubbed until they thought they had washed and scrubbed enough. Then they put it all back in and sewed him up. He lived into his mid 80s. This would have been done by a small town doctor in eastern Kentucky.
About 5 years ago Ms Hook had her appendix out. A friend of ours, a retired emergency room doctor, told us that a quick and dirty way to diagnose appendicitis was to take the right leg, hold it stiffly in line with the body and give a good hard smack to the heel. If it hurts where the appendix is, then that’s what you got. Sure enough that’s what the doctor did at the ER.
Anywho, that’s my $.02