appendicitis, that there are thousands of surgeons who are otherwise
competent, i. e., competent to perform the ordinary surgical and
gynecological operations, whom he would not think of permitting to
open his abdomen in case he personally suffered from an attack of
appendicitis. This condition is true not because it is an especially
difficult or dangerous operation, but because it requires an
appreciation of the conditions upon which success and failure
depend, and this appreciation can be obtained only by observing good
methods.

"In many of the ordinary surgical operations it is not necessary to
follow out the details with any great degree of accuracy, because
failure to do this will at most result in confining the patient to
bed a little longer than usual or necessary, while in the
appendicitis operation it is likely to result in the death of the
patient.

"This position, when taken in the discussion of appendicitis in
medical societies, has frequently given rise to severe criticism
because upon its face it looks as though appendicitis operations
should be performed only by the few who happen to have acquired
especial skill in this class of surgery, possibly at the expense of
the lives of a number of patients.

"This, however, is not the case. The operation is simple enough if
one will but take the pains to learn it, and every town of five
thousand inhabitants should have at least one man perfectly
competent to do such work. But if there is no such man available
then I would say most emphatically that the patient's chances of
recovery are many times greater with proper non-surgical treatment