Walker A R, Richardson B D, Walker B F, Woolford A
Postgrad Med J. 1973 Apr;49(570):243-9. doi: 10.1136/pgmj.49.570.243.
Information on appendicectomy-prevalence was secured on 15,317 16-20-year-old South African pupils and students—Negroes, Coloureds (Eurafricans), Indians and Caucasians. Data were also obtained on crude fibre-intake, frequency of defaecation, and transit-time of digesta. Among students, 18-20 years, appendicectomy was very uncommon in rural Negroes (0·5%) and periurban Negroes (0·9%), slightly more common in urban Negroes (1·4%), but very common in Caucasians (16·5%); prevalences in Coloured and Indian groups were low (1·7 and 2·9%). Rural Negroes had a far larger fibre-intake, greater frequency of defaecation, and much shorter transit-time; yet, in the four ethnic groups in urban areas, despite wide differences in appendicectomy-prevalence, data on these variables were similar. Differences in other aspects of the bowel milieu intérieur must therefore be sought. Corresponding studies were made on 1325 Caucasian pupils in Homes; their diet is less sophisticated (in respect of fibre, sugar and fat-intakes) than that of the general population. Pupils had slightly greater defaecation-frequency, lesser transit-time, and an appendicectomy-incidence only 23% of that of an appropriate control-group. The conclusion is reached that the causes of appendicitis are wholly environmental.
收集了15317名16至20岁南非学生（包括黑人、混血儿（欧非混血）、印度人和白种人）的阑尾切除率信息。还获取了膳食纤维摄入量、排便频率和消化物通过时间的数据。在18至20岁的学生中，阑尾切除术在农村黑人（0.5%）和城郊黑人（0.9%）中非常罕见，在城市黑人中略为常见（1.4%），但在白种人中非常普遍（16.5%）；混血儿和印度人群体中的患病率较低（分别为1.7%和2.9%）。农村黑人的膳食纤维摄入量高得多，排便频率更高，通过时间短得多；然而，在城市地区的四个种族群体中，尽管阑尾切除率差异很大，但这些变量的数据相似。因此，必须寻找肠道内环境其他方面的差异。对1325名寄宿白种学生进行了相应研究；他们的饮食（在膳食纤维、糖和脂肪摄入方面）不如一般人群精细。学生的排便频率略高，通过时间较短，阑尾切除率仅为适当对照组的23%。得出的结论是阑尾炎的病因完全是环境性的。
