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September 3, 1898


JAMA. 1898;XXXI(10):536-538. doi:10.1001/jama.1898.92450100034002k

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I make no claim to know anything which no one else has knowledge of, but have observed a few things in my surgical work which proved to be of enough importance to me that I became anxious that others might appreciate them more, and possibly save themselves and unfortunate patients trouble, suffering or life.

We often meet with adhesions between peritoneal surfaces, the legitimate ultimate result of peritoneal inflammations of all kinds, so numerous and extensive that all semblance to normal organs and landmarks is destroyed. These adhesions are always primarily conservative, but may lead to secondary grave complications. They may be so strong as to readily bear the patient's weight. The attenuation of these adhesions becomes possible when the inflammation causing it was traumatic, small in area, and a more or less constant tension was maintained thereafter. No man should for a moment think seriously of engaging in abdominal

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