J.Jpn. Surg. Soc.. 54(9): 753-762, 1953

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Original article

PROTEASE ACTIONS OF BACTERIA IN THE APPENDIX AS AN ETIOLOGY OF APPENDICITIS

The author has come to the idea that the primary cause of acute appendicitis may be necrosis of the mucosa of appendix due to the protease actions of bacteria in the appendixcavity and then the infection may be added secondarily.
The author, therefore, some experiments and obtained the following results.
1) By the use of Sörensen's formol-titration the author measured the protease action of bacillus coli group isolated from 9 normal and 16 inflammatory appendices and ascertained that the protease action of the latter was almost always stronger than the former.
2) In perforative appendicitis, I found the protease action of bacillus coli in the peritoneal cavity was stronger than that in the appendix-cavity.
3) I compared the resistance of the mucosae of i) appendix, ii) coecum and iii) ileum against the mycoprotease and the trypsin in 13 deceased persons. In all cases the author found the appendical mucosa was most easily digested.
From these results it may be reasonable to consider that the appendical mucosa, which is easily digestable by nature, is under some conditions destructed and changed necrosis by the action of the mycoprotease in the appendical cavity and that this process may take a large part in the etiology of the inflammation of appendix. (author's abstract)

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