Appendicitis became treatable in 1735 with the first appendectomy. When in history did physicians start associating the appendix with the symptoms of appendicitis? Were there previous (unsuccessful) attempts at appendectomies?

Hi. First of all sorry for the late reply. In reddit terms 2 days might as well be a year ago.

I mod over at /r/historyofmedicine and saw your cross-post over there. I did a quick search on this sub and realized that appendicitis related questions have been asked frequently and usually go without being answered. I decided to reply here in /r/askhistorians hoping more people will see the answer. That said I am a surgeon by trade and my postgraduate thesis was on appendicitis so I did a whole lot of research on the topic.

The oldest medical drawings of abdominal viscera did not include the appendix vermiformis, this is probably due to the fact that they were based on comparative anatomy of different species (with human dissection being frowned upon). In 1942 Leonardo DaVinci did include the appendix in his illustrations but there is no mention of it in the text that accompanies them. in 1521 Jacopo Berengario describes the appendix in text for the first time. In 1543 Andrea Vessalius once again includes drawings but no text explanation of the appendix in his masterpiece "De humana corpora fabrica" in 1543. In 1561 Gabrielle Fillipo coins the term appendix vermiformis to describe the appendix.

Concerning the symptoms of appendicitis:

In one of Hippocrates Aphorisms it is stated “Suppuration upon a protracted pain of the parts about the bowels is bad” which has led many to believe that it may refer to appendicitis. The greek medical texts speak of an Iliac and Colic passions. The iliac passion is described as pain above or around the navel and the colic passion as pain in the right illiac fossa. It was thought that iliac passion reflected upon disseases of the small bowel and the colic passions was a reflection of colonic disease. Therefore the classic presentation of appendicitis as a pain that starts around the navel and then migrates to the right iliac fossa might have been attributed to a "passing" of the disease from the small bowel to the colon. Some cases are described in text such as the one Fernellius wrote about: a 9 year old child with iliac passion that turned into colic passion, diarrhea was present and astringents were given. The diarrhea stopped but in its place fetid vomits appeared and the child died 2 days later. An autopsy was performed and revealed corrupt matter withing the abdomen.

In 1661 we have the first suggestion that the migrating pain could be a different pathological entity. This was proposed by Syndenham but instead of attributing the symptoms to the appendix he thought the iliocecal valve was to blame. In 1709 Boerhevae noted that "as long as this malady continues in its inflammatory stage, it often imposes upon those who are incautious under the name of a colicky pain, by whom it is, with the most dangerous events, ascribed to cold, to wind and to flatulencies, and accordingly ill treated by carminative and hot medicines, with the most fatal consequences.”

In 1735 the first successful appendectomy was performed by Claudis Amyand Geillaume while operating an 11 year old with an scrotal hernia and fecal fistula. When he opens the scrotum he finds the appendix has a perforation and he resects it. Parkinson was the first to publish a theory of appendicitis and proposed the drainage of pericecal abscesses. In 1827 Meiler proposes surgery as the treatment for appendicitis however Dupuytren opposes him and proposes the cecum as the origin of the disease. Since Dupuytrene was widely regarded as an authority in surgery Meiler's suggestion did not become the standard of care.

In 1880 Robert Lawson Tait was the first to make a diagnosis of appendicitis before taking the patient to the operating table. In 1886 Reginalf Heber Fritz published a compilation of cases treated with surgery and was the one that popularized the terms "Appendicitis" and "appendectomy". In 1893 Charle McBurney described the technique that carries his name (and is virtually the same one we use today) in 1900 Robert Fulton Weir modified this technique and it remained the gold standard for appendectomies all the way up to 1981 when Semm did the first laparoscopic appendectomy.

So I hope that covers your question.

*J. Berry and R. A. Malt, “Appendicitis near its centenal.,” Ann. Surg., vol. 200, no. 5, pp. 567–75, Nov. 1984. *H. F. Smith, R. E. Fisher, M. L. Everett, A. D. Thomas, R. R. Bollinger, and W. Parker, “Comparative anatomy and phylogenetic distribution of the mammalian cecal appendix.,” J. Evol. Biol., vol. 22, no. 10, pp. 1984–99, Oct. 2009. *G. R. Williams, “Presidential Address: a history of appendicitis. With anecdotes illustrating its importance.,” Ann. Surg., vol. 197, no. 5, pp. 495–506, May 1983. *L. Francis, “Appendix in,” in Clinical Surgery 1st Ed, 1987, p. 1581. *H. Ellis, “Appendix in Schwartz,” in Maingot´s Abdominal Operations, 8th ed, 1985, p. 1255. Appendicitis- Its Diagnosis and Treatment, John B. Deaver. Pp 1-53. *The Vermiform Appendix and Its Diseases, Kelley & Burdon. Pp 1-43 Louisville Medical News, Vol. XIX, 1885. Dugan, McCoy, Lancet. Pp 81,97,145, 47. *Proceedings of Phila. Co. Medical Soc. Vol. VIII, 1887. Pp 101. *Transactions College Physicians Vol. IX. 1887. *Lancet, Vol. I. 1888. Pp 527. *Phila. Medical News. 1887, 1892. *Private Correspondence, Dr. J. Vernon Ellson, Phila. 1927.