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May 24, 1902


JAMA. 1902;XXXVIII(21):1343-1345. doi:10.1001/jama.1902.62480210001001

The acceptance of this title presupposes that you will permit me to assume that certain cases of septic peritonitis of appendiceal, intestinal and tubal origin may become inoperable, i. e., that the interests of the patient may be better served at times through the adoption of non-surgical measures. This position must be conceded by the radical appendicitis operators in the "operate as soon as the diagnosis is made" class, when they are pinned down to particularly grave cases, for they all meet some cases in which they are unwilling to operate.

Septic peritonitis usually has its origin in some local point of infection and the gravity of the symptoms depends upon the virulence of the infection and the area of peritoneum involved through the diffusion of the process; those measures that tend to limit the spread of the infection and favor its localization to a circumscribed area must favor the

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