Appendicitis, fibre intake and bowel behaviour in ethnic groups in South Africa

Information on appendicectomy-prevalence was secured on 15,317 16-20-year-old South African pupils and students—Negroes, Coloureds (Eurafricans), Indians and Caucasians. Data were also obtained on crude fibre-intake, frequency of defaecation, and transit-time of digesta.

Among students, 18-20 years, appendicectomy was very uncommon in rural Negroes (0·5%) and periurban Negroes (0·9%), slightly more common in urban Negroes (1·4%), but very common in Caucasians (16·5%); prevalences in Coloured and Indian groups were low (1·7 and 2·9%). Rural Negroes had a far larger fibre-intake, greater frequency of defaecation, and much shorter transit-time; yet, in the four ethnic groups in urban areas, despite wide differences in appendicectomy-prevalence, data on these variables were similar. Differences in other aspects of the bowel milieu intérieur must therefore be sought.

Corresponding studies were made on 1325 Caucasian pupils in Homes; their diet is less sophisticated (in respect of fibre, sugar and fat-intakes) than that of the general population. Pupils had slightly greater defaecation-frequency, lesser transit-time, and an appendicectomy-incidence only 23% of that of an appropriate control-group.

The conclusion is reached that the causes of appendicitis are wholly environmental.

A look at cryosurgery

Cryosurgery provides a means of tissue destruction which is easily and accurately controllable and which can be applied to remote areas of the body. The mechanism and properties of freezing are discussed with particular mention of the maximum freezing effect and its clinical application. The application of cryosurgery to various clinical problems is discussed.