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April 18, 1903


JAMA. 1903;XL(16):1084-1085. doi:10.1001/jama.1903.02490160036006

So long as the sanitary conditions in this country continue indifferent or bad as they are at present the question of treatment of typhoid perforation will continue to be of great importance, for typhoid fever is one of the most common diseases in many of our large cities. This interest in the subject of perforation will continue, not only because of the frequency of the complication, which has been estimated by various authors to occur in from 1.2 per cent. to 11.38 per cent. of all cases, but because of the almost absolute certainty of a fatal outcome unless operative treatment is adopted. Much of the recent interest in this subject must be credited to Keen, who, by his careful study of a large series of cases collected from the literature, was among the first to point out1 the most important features in diagnosis, rational methods of treatment and the

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