Although appendicitis has long been definitely recognized as a clinical entity, there is at the present time no unity of opinion among the various investigators as to its pathogenesis. Most authors agree, however, that infection is an important factor in its production. One finds a variety of predisposing factors described as favoring the infection, but there is a disagreement as to the mode of entrance of the offending organisms into the tissue of the appendix.
Aschoff1 has maintained that the disease has an enterogenous origin, while Kretz2 has endeavored to demonstrate the localization of organisms in the follicular apparatus of the appendix by way of the blood stream, gaining entrance thereto, particularly, from the tonsils. The latter investigator was of the opinion that the streptococcus is the exciting cause, as he could demonstrate grampositive cocci within the vessels in the submucosal follicles. Recently Rosenow,3