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June 5, 1909


Author Affiliations

Surgeon to St. Anthony's Hospital, University Hospital and Louisville City Hospital, and Professor of Abdominal Surgery and Gynecology, Medical Department of the University of Louisville LOUISVILLE, KY.

JAMA. 1909;LII(23):1821-1824. doi:10.1001/jama.1909.25420490017002b

For postoperative ileus we should substitute postoperative paralytic obstruction, partial or complete, temporary or permanent; for the word "ileus," in its etymology, has no pathologic significance and should be eliminated from surgical nomenclature.

Partial or complete intestinal obstruction may be either primarily paralytic, or mechanical, followed by loss of motility and peristalsis if operation is delayed.

The primary paralytic form of obstruction may be caused (1) by violent inhibitory impulses transmitted to the muscle walls of the intestines from the central nervous system by the splanchnic nerves through the sympathetics; (2) by impairment or destruction of the energy in the neurenteric plexus, and the myogenic force in the walls of the intestines on which motility and peristalsis depend, resulting from the poisonous action of bacterial enzymes from the intestines or the peritoneal cavity on the nerves or muscles in the bowel walls, or from traumatism; or (3) by the combined

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