Abstract
Two hundred years after its anatomical description, the appendix was observed to be the site of inflammatory disease. This was not widely accepted until the publication by Fitz 120 years later. American surgeons led in demonstrating that early appendectomy was safe and life saving. Perforation of the appendix with peritonitis continues to be a significant problem, but the mortality rate has dramatically declined. Appendiceal disease has clearly affected the course of history.