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February 12, 1927


JAMA. 1927;88(7):502-503. doi:10.1001/jama.1927.02680330054030

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To the Editor:  —In The Journal, Nov. 27, 1926, p. 1831, Dr. Carl M. Sautter takes exception to my method of external opening of abscesses descending into the neck and mediastinum. He says:Glogau, in his article on phlegmonous conditions of the neck, advises carrying an incision down to the sternum and sealing off the mediastinum above the clavicle with gauze to prevent a descending abscess; he cites two cases in which this procedure was adopted, which terminated fatally, with some pus found in the mediastinum at postmortem. The advisability of this technic as a routine method, however, seems questionable because of the relative infrequency of the condition. Furthermore, from a cosmetic point of view, one naturally avoids unsightly scarring as far as may be, and also the possibility of defeating one's purpose by unintentional infection of the mediastinum by this form of prophylactic surgery. With the modern facilities available,

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