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May 16, 1925


Author Affiliations

St. Louis Professor of Surgery, St. Louis University School of Medicine

JAMA. 1925;84(20):1491-1492. doi:10.1001/jama.1925.26620460001012

At least 75 per cent. of the ascitic forms of tuberculous peritonitis are cured by laparotomy. Spencer Wells, in 1862, unintentionally operated on a patient with tuberculous peritonitis, who made a prompt recovery. He had diagnosed the condition before operation as a case of ovarian cyst. Operative treatment was first advised by Koenig, in 1884, but it never has been known just why a mere laparotomy cured the condition. Hildebrandt thought that the postoperative hyperemia was the cause. Others thought it was simply the admission of air. Gatti believed that the fluid exudate that follows operation exerted an injurious or bactericidal effect on the tubercle bacilli and thus promoted recovery. Murphy had the good fortune to see the peritoneum three or four days after operation for tuberculous peritonitis. He found that it was intensely congested, that its vascularity was greatly increased, that its gloss was almost or quite abolished, that

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