THE TOTAL picture of acute appendicitis at the present time has a number of components. Some of them are creditable. Others are not. The situation may be summarized as follows:
1. To our professional shame, this disease is still slaying its thousands. The death rate per 100,000 in the United States, which was 9.7 in 1900 and 15.2 in 1925, has fallen progressively since the latter date and last year declined to an all-time low of 1.7.1 This remarkable decrease is somewhat less gratifying than on first glance it might seem when it is recollected that a death rate of 1.7 per 100,000 means that at least 2,600 persons died in this country in 1952 of a disease that has been well described as eminently treatable.
2. The mortality in simple acute appendicitis has always been low and is now minimal. Deaths in this type of disease are practically