Young girl having a wash. Ref: PAColl-5671-19. Alexander Turnbull Library, Wellington, New Zealand. /records/23176987

July 1919

(To the Editor.)

Sir, I have been particularly interested in Dr. Collins’s note on the relation of enamelware to appendicitis, as this theory was ventilated by me 15 years ago. At that time I wrote to Sir Frederick Treves and to Dr. Howard Kelly (the well known American surgeon) asking them to have the theory tested by a competent pathologist and microscopist. No reply was received from the former, and the later said the idea was very interesting and possible, and was worth considering. Nothing was done. I then wrote a short article to the “Practitioner” on the subject, but whether it was published I cannot say as I had, just at that time, given up taking this journal. For years I preached this idea to all and sundry, but with little effect.

The following is practically a resume of that article, allowing for the period when it was written:—

“Fifteen years ago, I was making a lotion with which to dress a spine case and used a metal instrument to crush a tabloid in an enamel jug. I poured the lotion into a glass measure, and a gleam of sunshine passing through the latter shewed myriads of fine jagged glassy pieces floating in the fluid. I at once judged these to be bits of enamel, and it flashed through my mind that these were the cause of appendicitis.

Enamel is a glass. It was gradually introduced into domestic use about 25 or 30 years ago, about the time when appendicitis was beginning to cause some stir in medical circles by its increasing frequency. From that time this increase has gone on at an appalling rate, and has been coincident with the general use of enamelware for domestic purposes. It is clear that some new and widespread cause for appendicitis has come into our lives within the last generation, that affects all classes, rich and poor, and all ages, men, women and children.

It is reasonable to assume that a considerable amount of the wear and tear of enamel eroded by stirring with metal spoons, in the shape of microscopic chips or even larger pieces becomes mixed with the food and is swallowed. Badly made enamelware would probably be especially brittle. It is easy to imagine these microscopic bits of glass cutting their way through a blind tube like the appendix and allowing equally microscopic germs to invade the peritoneal surface, setting up trouble around the organ—apart from a chip of a broken tooth, a spicule of bone, or bit of oyster shell, I judge enamelware to be the main cause of appendicitis, and it answers all the possibilities mentioned above.”

I trust that now, after Dr. Collins’s definite statement, the subject will be investigated on a large scale, and so give a chance of ridding the world of a terrible scourge. I am, etc,

F. W. GORDON

Auckland, 10th July, 1919.

‍