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March 7, 1931


JAMA. 1931;96(10):751-754. doi:10.1001/jama.1931.02720360021005

The past decade has witnessed radical changes in the treatment of thrombo-angiitis obliterans.1 Former teachings concerning this disease gave rise to the impression that the ultimate outcome in almost every case of thrombo-angiitis obliterans was amputation of one or more extremities because of the inevitable occurrence of gangrene. This erroneous idea has been so impressed on physicians that patients, even in the early stages of the disease, are often looked on as hopeless, and doomed to a future minus legs and arms. I have known of instances in which immediate amputation of both legs was advised because of the presence of incipient thrombo-angiitis obliterans, without ulceration or gangrene. A still larger number of cases of thrombo-angiitis obliterans are submitted to high amputation because of the presence of a small area of gangrene limited to one toe. In many textbooks the disease is described as a progressive series of amputations,

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