Appendicitis the Hard Way
The appendix is located in a dead end part of the cecum, source Tilden(1921)
Among our society today there is a near universal view that appendicitis is dangerous, and that the right thing to do is always go directly to the hospital. And, given the possible consequences of peritonitis that reputation deserves respect.
Even though appendicitis is more common in the young, I managed to get it this summer. This writeup documents the progression of my illness and recovery from it using entirely natural means. Using a treatment plan based on the old time "Hygenist" view of appendicitis, though I'm alive and well, it was certainly not easy. Do think carefully before relying on this material, its not for everyone, and consulting trained medical professionals is always advised, even if you decide to heal it naturally.
Appendicitis is an inflammatory condition of the lower reaches of the descending colon, this area being known as the cecum. Either the appendix itself can be inflamed, or the opening may be blocked by infections occurring in the cecum. Parasites, constipation, heavy metal loading, certain kinds of food irritants can all be factors. It can be confused with lymphadentitis, diverticulitis, and other abdominal conditions.
In recent times more is becoming known about the role of the appendix as an important part of the lymphatic/immune systems. The tonsils, spleen, appendix all play small but important parts in fighting infection, and while none were thought to be critical, the removal of any of these organs is now shown to increase infection recovery time 1, and increase your chances of cancer later in life 2. Increasingly, treatment these days is with antibiotics rather than surgery 34.
Being fundamentally of the belief that the body is capable of healing itself, at the first signs of it, I delved into a more motivated than usual literature search. This turned up a group of old time MDs who called themselves the hygenists, practicing from the 1900s onwards. Among them was Dr J.H Tilden, whose 1921 book Appendicitis, the etiology, hygienic and dietetic treatment was invaluable to me. Here he describes how the new science of surgery rapidly replaced traditional methods of treating digestive tract inflammatory conditions:
"Following immediately on the announcement of Lord Lister's antiseptic surgical dressing which rendered the invasion of the peritoneal cavity comparatively safe, ... it was soon legitimatized by professional opinion, and rapidly became standardized as a necessary procedure in all questionable cases--in all obscure cases of abdominal disease--where the diagnosis was in doubt... The wave of abdominal operations that swept the country in the last quarter of the nineteenth century was appalling. The slightest pain during menstruation, or in the lower abdomen, in fact every pain that a woman had from head to toes was put under arrest and forced to bear false witness against the ovaries... About 1890 appendicitis began to attract the attention of those surgically ambitious. ... those who were making history in the new surgical fad--appendicectomy--and they got busy, and, ... it was no time before a surgeon who had not a hundred appendicectomies to his credit was not respected by the rank and file....To-day there is no other disease which brings surgery so quickly to mind as does appendicitis, especially if the victim can stand for a good, large fee." Tilden(1921:5).
After he saw the error of his ways he went on to routinely treat appendicitis successfully prescribing nothing but water and bed rest. Dr. W. Hay was another early doctor who witnessed the arrival of the surgical 'craze' with some hesitance.
"From a surgical experience that covers only the first 16 years of [my] practice, and for the past 24 years [I] have handled perhaps ten times as many cases. In all that time [I] have referred but three cases to the surgeon...Over 250 cases of acute and chronic appendicitus have been handled during this very unsurgical period, not one of which has resulted fatally, even including 14 cases that had ruptured before coming to treatment." Hay(1932:97).
"Too often the teeth are extracted, the tonsils extirpated, the appendix removed, all without going back far enough to find the reason for the predispostion that permitted this occurance, yet the true field of search should always be the mode of life that has resulted in such accumulaton of debris. Hay(1932:17).
Hays writing is lucid and replete with patient anecdotes, and his lengthy book well worth a read. Another hygenist school MD was Dr. Henry Bieler who practiced from the 20s and into the 70s, documented the following case, which follows Tilden's description more or less exactly.
"I have always believed that with special care a case of ruptured appendix could be cured without surgery. Here is an example: The patient was a forty-six-year-old man ... About two A.M. he was awakened by a severe pain in his abdomen... He was very uncomfortable and had a temperature of 100, accompanied by much nausea and vomiting. This brought up not only the previous night's dinner but the contents of his small intestine as well. About forty-eight hours later the pain suddenly ceased and he felt much more comfortable, but his fever rose to 101 and his pulse was rapid and thready. It was then that I was called. Strangely enough, the patient did not appear to be ill. In fact, he said he felt like getting up and going to work the next morning. His pulse of 120 to the minute, his temperature of 101 and his previous symptoms all pointed to an acute appendicitis. I concluded that the appendix had ruptured, after which the pain had ceased. Since he had had no medication, his symptoms were not masked by analgesic drugs ... "I don't want surgery," he said, "if it can be avoided." "Fine," I told him, "but you must consent to hospitalization and surgical consultation while I treat you without the use of drugs or the knife." He agreed." Bieler(1965:159)
I reproduce the case study in full, below, because such material is scarce and important. I shall now catalog what happened to me. Given that contemporary references of people healing their own appendicitis are mighty mighty scarce 3, just maybe this will help to break the ice.
Day 1, awoke in the early hours with sudden onset abdominal discomfort. It felt like gas cramps / bloating which I initially attributed to cabbage at dinner the previous night. Being somewhat attuned to my digestion, I intuitively withheld further food. During the day the pain sharpened and focused to the right of the naval, then it dropped to the McBurnies point just medial to the ISIS (top front crest of hip bone), and a mild fever started. I spent a couple of sleepless nights not being able to get comfortable, only taking water on a thirst dictated, small sip basis. They were difficult days. The only way I could get semi-comfortable was flat on my back with knees up. Attempts to walk were very painful.
Day 4, the fever broke with temp back to 37C. Things got much more comfortable, just as Tilden predicted. I could now lie still without pain, it only hurting when I moved. Elevating my right knee slightly on a pillow helped. My urine was now bright fluorescent orange (not brown) much of the time. At this point I commenced rehydrating, taking 2L of water per day. I also started reading in earnest and the symptoms did appear to be classic appendicitis. At this point every single person around me, without exception, produced a story about a relative who nearly died from appendicitis, imploring me to go to the emergency clinic, including my partner. This is up there with the loneliest things you can experience in this life.
However, I decided to wait out the 2 to 4 weeks that the hygenists said that appendicitis takes to resolve itself. My argument to anyone that asked was simple, you cant hold beliefs on 6 days then throw them out on the 7th. Further encouragement, in case I needed it, came from the contemporary Doctor Schultz 1: "I have three rules for appendicitis, dont go the hospital, dont go the hospital, dont go the hospital".
At this point, the cecum area remained tender to the touch, and it developed into a swelling the shape and size of a walnut to the right of the naval. My treatment through this period consisted of very dilute ginger and lemon orally, non-inflationary herbs sage and thyme, alternating hot and cold water sprayed on the skin of the abdomen, daily sun baths, and short occasional hot baths. Colon flushs occasionally, as needed, yielding a quantity of parasites. Most nights I'd sleep OK til 3am, awaking every time to dreams of something trying to get me, then lay awake quietly til noon. My energy levels cycled up and down a bit, always the grimy coated tongue.
Day 8 the walnut shaped inflammation reduced to a more diffuse tenderness, then to being barely tender at all. Much as I tried to rest, (as the fast went on hindsight would teach me that it wasnt nearly rest enough), I ended up spending a lot of time on the computer and trying in vein to keep the household from descending into chaos.
Day 10 arrives, and i began to have doubts that my condition is as serious, thinking that it was a milder case of inflammation. Tilden outlines a process broadly as follows, the inflammation either in the appendix or the cecum causes a global abdominal rigidity which is painful and lasts 3 days, then an abscess forms to quarantine the blockage/damaged area, then after some time the abscess bursts safely into the cecum. (He is adamant that the appendix will only burst into the peritoneum if one or more of the following misinterventions occur: morphine is given for pain (interferes with the abdominal rigidity required to protect the inflamed area); excessive manual palpitation / examination (literally bursts the abcess from the outside), and continued food intake (forms gas and restarts peristalsis putting pressure on the abscess from the inside).
My worldly responsibilities were starting to press, but really people are pretty patient, i generally take the opportunity to savour what appears to be a healing crisis for me, both physically and emotionally.
But, influenced by modern day Schultz who allows juices, i tried apple and carrot, which went down ok, but within an hour produced a lot of gas. Also tried clear vege broth. Just one sip of that gave me a stomach ache. My appetite throughout was non-existent, and even looking at food, smelling it, i was just no, no thanks. And I noted that it was common for Tilden's patients to lose faith at this stage, and try to prematurely break the fast. So i decided to stick with water.
Day 14, feeling unsure I went to see the naturopath. The 30 min car journey was very very uncomfortable, I never realised cars vibrate so much. She did some work on my reflexology points, and this greatly settled my stomach. My weight lately 79kg, was now 70.4kg. At this time i noted a new tenderness just beneath the sternum, which hung around for 2 days, and turned out to be releasing liver/gallbladder stones, which flushed out in subsequent days.
Day 16, was a crisis of some kind, awoke in a trance like state with very shallow breathing, which worried me at first, but on arising I came right, indeed felt somewhat renewed. In the days that followed I would come to take the rest imperative more diligently, now limiting electronic device time to a few hours in the mid afternoon, when id dig ever deeper into the hygenists books.
Day 22, I have a bit of a melt down, questioning my faith in the process. Strangely this galvanises support from those around me.
Day 24, woke up for the first time with a happy dream. My urine has finally returned to normal color. Left to my own devices and in a more supportive environment, i would have continued the fast until either Tilden's landmark bowel motion, or my appetite returned. However as my gut now feels healed, I decide to break the fast (again and not for the last time) Taking a half glass of fresh apple/orange/carrot juice each hour for two days, then in desperation some yoghurt. Again this all gives me bad gas and stomach ache, and I stop (again). Now I've got an inflamed throat and tonsils as well, great.
Day 26, sleeping lots, throat now improved. The final few days of the fast was a significant period where I felt at peace and a strong sense of well being. I can now also smell food. Eyes and skin very clear
Day 28, having done my 4 weeks, enough is enough, and under pressure from family and work, I go to see the doctor. The car trip is this time OK, and I'm surprisingly well treated by the clinic. After explaining that I've been fasting for 28 days, they provide me with a place to lie down while the doctor arrives. Blood pressure, pulse, temp, blood sugar are all normal. The doctor, a man of few words, felt my abdomen, and said that if anything I was dehydrated. The blood tests for inflammatory markers turned up nothing, and I was sent home with a clean bill of health. Me, I already knew all this, but for everybody else this was occasion for great relief.
However standing as I was at the top of the mountain, now I had to get back down... So learning from previous attempts, and knowing that my gut was going to have to be jump started, for the first day i took just a very small diluted quantity of apple juice, with no other purpose than to tell my gut that its time to wake up. I dig out all the food movies i could find, Julie and Julia, Chef, A Hundred Foot journey (for reference should the need arise yourself). I smell lots of different kinds of food. Each day adding back something new, one at a time. Letting each meal to digest. Trying to do good food combinations.
Day 1, 1 cup raw apple juice diluted to 2 cups.
Day 2, as day 1, plus 1/4 cup dilute berry and spinach smoothie
Day 3, as day 1, plus 3/4 cup smoothie, plus 2 cup strained broth made from beetroot,leek,celery,zuchini and miso.
Day 4, half a pear, 1 cup of fresh berries, 2 cups broth,
Day 5, 1 cup stewed apple, 2T yoghurt. 1.5 cup lightly cooked soup of cubed beetroot, celeriac, silverbeet, with tamari.
Day 6, 2 cups smoothie (berry,pear,banana,dandelion,plantain cellery), 2 cups salad (lettuce,avocado,tomato,cucumber,herbs,lime juice), 1 cup stewed apple and prune. first bm.
Day 7-10, smoothie, soup, salad with fish or egg.
The entire first 6 days i had some gas but not too bad, i had to lay down after each meal, feeling as it did like 97% of my available energy was being used for digestion. This whole period i was able to do some things out of bed, sitting quietly, but attempts to remain standing for more than a minute or two gave me a sort of heart burn / light-headed-ness of the gut, which is a very strange and uncomfortable feeling. Normal gut feeling and the ability to function normally didnt occur until after the 10th day.
Judging by the absent pus bowel movement, I can only conclude I had a milder dose of it, walnut not grapefruit. My story shows that you dont have to be either young, or a Standard American Diet type of person to get appendicitis. However appendicitis can in some circumstances (please consult your doctor, std disclaimer) be healed without recourse to surgery or antibiotics. However... be prepared to lose 15kgs, to battle your family and friends, and ponder every single day ones own mortality.
I started out reasonably fit, and ironically I had for some months prior been making efforts to clean up my diet and exercise regime. But with a growing collection of physical symptoms, plus a recent sense that many things in my life weren't at all ideal. Hay talks about this effect of body toxicity on mental and emotional well-being. It makes a lot of sense, and I do feel much more content after the ordeal.
But... at 5 weeks worth of recovery time from this, you can sorta see why busy modern folk tend to take the conventional route, and opt for surgery.
3 When A Burst Appendix Doesn't Kill You Avail www.commonhealth.wbur.org/2012/07/burst-appendix-appendectomy
- Tilden, J.H (1921), Appendicitis, the etiology, hygienic and dietetic treatment, avail www.archive.org/details/appendicitisetio00tild
- Hay, W.H (1932), Health via Food, avail www.soilandhealth.org/book/health-via-food/
- Bieler, H.G (1965), Food is your best medicine, Ballentine Books, New York.
Extract from Bieler's book, case study.
"I have always believed that with special care a case of ruptured appendix could be cured without surgery. Here is an example: The patient was a forty-six-year-old man, interested for Years in a careful choice of natural food. Small in stature, he was well developed, not obese, and weighed 135 pounds. His wife and their two children, whose births I attended, were also my patients: All were on well-chosen diets and all were healthy. Both patients were teachers who often attended social dinners; it was at one of these that the husband made an unwise choice of food. On July 19, at a Mexican dinner, he ate a large portion of tamale pie and green salad heavy with mayonnaise, and topped off liberally with ice cream.
About two A.M. he was awakened by a severe pain in his abdomen. His wife gave him enemas with good results, but the intensity of the pain increased. They both concluded that it was due to an acute indigestion. He remained in bed all day, and since he had no appetite, he merely sipped water. Enemas were repeated at four-hour intervals. He was very uncomfortable and had a temperature of 100, accompanied by much nausea and vomiting. This brought up not only the previous night's dinner but the contents of his small intestine as well. About forty-eight hours later the pain suddenly ceased and he felt much more comfortable, but his fever rose to 101 and his pulse was rapid and thready. It was then that I was called.
Strangely enough, the patient did not appear to be ill. In fact, he said he felt like getting up and going to work the next morning. His pulse of 120 to the minute, his temperature of 101 and his previous symptoms all pointed to an acute appendicitis. I concluded that the appendix had ruptured, after which the pain had ceased. Since he had had no medication, his symptoms were not masked by analgesic drugs. The last few enemas returned uncolored and all movement of gas in his
intestines had stopped. "I don't want surgery," he said, "if it can be avoided." "Fine," I told him, "but you must consent to hospitalization and surgical consultation while I treat you without the use of drugs or the knife." He agreed.
The surgical consultant, at staff member of Bellevue Hospital and a graduate of Columbia University Medical School, a competent man of great experience and a good friend, was willing to Stand by and make daily examinations with me while watching the progress of the patient. The first examination in the hospital, on July 23, showed a tender mass in the region of the appendix--a mass about the size of an orange, which could also be palpated by rectum. There was no indication of peristaltic activity (alternate waves of constriction and dilation in the alimentary canal). Enemas were useless and cathartics strongly contraindicated. The most careful auscultation of the abdomen disclosed no evidence of the slightest movement of intestinal gas. It appeared that nature, in her wisdom, had ordered a state of complete quiet and rest.
The patient had slight nausea only when he changed his position in bed; vomiting had ceased. He was satisfied with small pieces of ice by mouth; there was no desire for food. The white blood count was 20,000 with 96 percent polymorph cells, which indicated an abscess with localized pus. His blood pressure was 100/70 with an irregularity of heart action. There was no abdominal pain except on pressure. He slept well.
The following day, July 24, the nausea was negligible and pain on pressure was lessened. The patient was very comfortable in bed and enjoyed reading or listening to music. He also enjoyed small pieces of ice by mouth. I noted an abdominal mass the size of a grapefruit. The surgeon found the rectal mass larger and of more solid consistency.
On July 26, the white blood count had dropped to 12,000 with 85 percent of polymorphonuclear leucocytes. (It is the white blood cells that act as policemen.) This was an indication that the abscess was well walled off and that there was less absorption of the toxins. The temperature had dropped to 99.6; the pulse to 90 and of fairly good strength. The blood pressure was 100/70. There was no nausea or vomiting. The consistency and size of the mass was the same.
Next day, the condition of the patient remained unchanged. There was not the slightest sign of peristalsis. A small, warm- water enema was given daily, and was returned uncolored and with no traces of feces.
When I visited him on July 27 he expressed a desire for grapefruit. The juice of a ripe grapefruit, diluted with two parts of water was given, along with small pieces of ice. The temperature remained at 99.6. There was no peristalsis and no pain, even on pressure. Yet the mass remained the same size. The patient was very comfortable, unfrightened and enjoyed his rest. My friend the surgeon was flabbergasted. I think he still entertained thoughts of draining the abscess. I believed that the abscess, although well walled of, would gradually "point" toward the adjacent wall of the large bowel, through which it would finally rupture and that there would be no peristalsis until the wall of the abscess broke and its contents were discharged into the large bowel. Then a putrid, blood-and-pus bowel movement would follow. This would occur from the twelfth to the fourteenth day after the onset of the attack.
There was no change the following day, July 28, except that the temperature had dropped to 99.
On July 29 there was still no evidence of peristalsis. The size of the mass remained the same. But the temperature dropped to 98.6; blood pressure to 90/60. The heart was regular with no cardiac exertion, the pulse 80. The patient remained satisfied on the diluted grapefruit juice and reported no craving for other foods. The white blood count was still 12,000 with 80 percent polys. The urine was negative, as it had been from the Start. During the entire attack the only finding in the urine was an increase in the indican content (which meant that the putrefactive material was being
absorbed into the blood from the bowel).
There was no change on July 30. The patient was not the least bit hungry. He was entirely satisfied with the grapefruit juice. The temperature was 98.5. The surgeon found conditions the same.
On July 31 the mass was smaller. The white blood count remained at 12,000, the polys had risen again to 85 percent. We were ready and impatient for the rupture of the abscess into the large bowel. The patient slept like a log at night and enjoyed several naps during the day. He looked thinner but healthier than ever. And he felt strong enough to do anything he cared to do. This included daily short strolls in the hospital corridor.
On August 1 the white blood count dropped to 11,000 with 83 percent polys; the blood pressure and pulse remained the same.
On August 2 the rupture finally occurred. The abscess mass was no longer palpable. The next morning there was a copious, spontaneous bowel movement which contained the contents of the abscess. The white count dropped to 8,000 wrth 80 percent polys. Now, for the first time, the patient developed an appetite. He weighed 110 pounds with blood pressure 100/60 and pulse normal at 70 beats to the minute. No mass was felt either by rectum or abdomen. At six-hour intervals continued to pass a small amount of fetid material from the bowel.
By August 5 he was drinking milk and eating egg yolks, cooked cereal, stewed ripe fruits and cooked non-starchy vegetables, such as string beans and soft squash. And he was discharged from the hospital. By September 12 he weighed 127 and was physically sound. Careful rectal examination showed no evidence of his former pathology.
One month later, he weighed 131, which I considered to be his normal weight. He was given a small dose of thyroid extract daily--one thirtieth of a grain--to help build up his thyroid gland, which had been depleted somewhat in its effort to detoxicate the body during the attack. This dosage was continued for about six months. Other than the thyroid the patient had no medication.
On July 21, when the appendix had ruptured and the acute pain disappeared, he was not exposed to heavy, deep palpation. Because of that, the pus from the broken appendix was nor disseminated and no general peritonitis occurred. Once the appendix had ruptured, nature confidently built a wall around the fetid material and a localized peritonitis resulted, non-toxic to the patient because he was "properly treated." This proper treatment consisted of protecting the patient from well-meaning relatives who would have insisted on giving him "good nourishing food to keep up his strength." Had he been fed such food, even in small amounts, his fever would have mounted, his flatulence would have become unbearable, his pain would have increased, and his nausea and vomiting would have returned.
As treatment for this host of unfortunate conditions, large doses of sedative drugs might have been prescribed drugs which could have paralyzed his sympathetic nervous system. This would have increased the abdominal gas to the point where "life-saving" surgery would have been necessary." - Bieler(1965:159)
How i recovered from appendicitis the old fashioned way... and got a new lease of life thrown in for free.