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November 18, 1944


JAMA. 1944;126(12):789-790. doi:10.1001/jama.1944.02850470053026

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To the Editor:—  I am rather astonished at your editorial in The Journal, October 21. Apparently the underlying pathology of these lesions is not understood. Ileitis is just one of the manifestations of chronic nonspecific granulomatous lesions of the alimentary tract; and unfortunately this has been lost sight of in the communications which have appeared in the literature.As I stated in my paper in Surgery for August 1939, the available facts indicate that hypertrophic granulomatous lesions are encountered in infections with amebas, in infections by various strains of the dysentery group, in the group of so-called nonspecific ulcerative colitis associated with previously existing conditions, such as diverticulitis, or as a chronic development unassociated apparently with any preceding condition. In the gastrointestinal tract the characteristic part of the lesion consists in a spread of a surface lesion to an intramural position in the wall of the alimentary canal. Essentially the

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