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June 28, 1890

A PLEA FOR EARLY OPERATIVE INTERFERENCE IN ACUTE PERITONITIS, WITH ESPECIAL REFERENCE TO THE SO-CALLED IDIOPATHIC PERITONITIS IN CHILDREN.Read in the Section of Diseases of Children at the Forty-first Annual Meeting of the American Medical Association, Nashville, Tenn., May 20, 1890.

Author Affiliations


JAMA. 1890;XIV(26):921-926. doi:10.1001/jama.1890.02410260005002a

A perusal of the record of results of strictly medical treatment in acute peritonitis, since that disease was established as an entity by Bichat, in 1802, is not conducive to professional conceit. Before the introduction of the opium treatment by the late Dr. Alonzo Clark, in 1850, the disease was almost invariably fatal. Prior to Clark's innovation opium had been given in moderate doses by Stokes, Graves and others, for its anodyne effect. Clark, however, advocated putting the bowels, as he expressed it, in "opium splints" through the medium of full narcotic doses of the drug. According to this eminent authority the criterion for the administration of the drug is the production of the following symptoms: "Subsidence or marked diminution of the pain; some or considerable tendency to sleep; contraction of the pupils; reduction of the breathing to twelve respirations per minute. In the favorable cases a considerable reduction in