The world, as mapped by frequency of cholera cases

This really fascinating image comes from a Scientific American guest blog post about the appendix. What does the appendix have to do with cholera? Turns out, the more we study the appendix, the more it appears that this organ—once thought to be useless—is actually a storage system that allows your gut to repopulate itself with beneficial bacteria following a bout with a dramatic, gut-wrenching such as cholera.

This theory makes a lot of sense, but it hasn't been proven yet. The blog post, written by Rob Dunn, tells the story of a couple of studies that seem to add further support to the theory. In one, 11% of people with an appendix had a recurrence of Clostridium difficile infection, while 48% of those without an appendix had a recurrence.

Grendell’s results do not prove Parker is right. Science does not work that way. More tests, even true experiments, need to be done. Maybe there was something else that differed between individuals with and without their appendixes. Maybe the result only applies to the mostly white population Winthrop hospital serves. Maybe the immune system plays a more important or different role than Parker envisions. These “maybes” are part of what make science beautiful — the idea that each question, each test, and each day, lead to more questions. Every good question is a road that goes on forever, diverging and bounding forward, sometimes quickly, other times more slowly, as new paths emerge and some of the old ones run straight into brick walls.

Where does this leave us? In your body is an organ that appears to be/may be/could be helping out the bacteria in your life so they can, in turn, help keep you alive. If you do not have your appendix anymore, you may be at an increased risk of recurrence and even death when confronted with a pathogen like C. diff., cholera or any of a wild kingdom of other pathogens. This possibility raises the question of what to do if your appendix (or your child’s appendix) becomes inflamed. First things first, you should seek medical attention. As for what the treatment should be, while appendicitis can be deadly, recent studies suggest some, but not the majority, of cases of appendicitis can be resolved using antibiotics, though the topic is an active area of research and little is known about the prognosis for individuals treated with antibiotics for appendicitis later in life7. Might there, some day, be solutions other than surgery and antibiotics, solutions that aim at restoring the sanctuary of the appendix? Maybe. Until then, doctors keep cutting infected appendixes out. When they do, when they hold them up, they hold up a symbol — a somewhat gross, pinky-finger-sized symbol –both of our complex relationship with other species and of how little we know.



  1. I had assumed it was spelled Clostridium defecile, because it makes you defecate.    Glad I won’t make that mistake again.

  2. The appendix usually is removed because it gets all swole up…

    and on this map poor Africa looks somewhat like a half-necrotized human heart.

    Damn.  Can the Dark Continent get a break? 

  3. After my appendix tried to kill me, I’m pretty glad it’s not in there anymore.
    Mind you, by the time they got it out it was perforated AND gangrenous :)
    Remember, if you have a really bad stomach, and get a pain in the lower right of your belly (as you look at it), then go see a doctor. 
    Waiting a day or so ‘because it’s probably nothing’ is a rubbish idea.  Trust me on this.

    1. Hey, mine was perforated and gangrenous too! Can I try to one-up you by saying I had salmonella and typhoid fever at the same time?

      The village doctor in Tuscany where I was staying told me to wait a few days because it was nothing….

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