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January 1935


Author Affiliations

Assistant Physician, Thorndike Memorial Laboratory, Boston City Hospital; Instructor, Department of Medicine, Harvard Medical School CHICAGO; Research Fellow, Thorndike Memorial Laboratory, Boston City Hospital; Assistant Resident, Fifth Surgical Service (Harvard) BOSTON
From the Thorndike Memorial Laboratory, Second and Fourth Medical Services (Harvard), and the Fifth Surgical Service (Harvard), Boston City Hospital, and the Department of Medicine, Harvard Medical School.

Arch Surg. 1935;30(1):14-29. doi:10.1001/archsurg.1935.01180070017002

Recent studies of postoperative pulmonary complications have indicated that bronchopneumonia, bronchitis and collapse of portions of the lung show the highest incidence.1 These three complications may logically be considered together since they occur together postoperatively and have long been observed by pathologists in the same lungs.2 It seems possible that they have certain etiologic factors in common.

A thorough study of such etiologic factors as infection, diminished ventilation of the lungs and bronchial obstruction has shown that no single one adequately explains the development of pulmonary complications. Infection by pneumococci occurs regularly in postoperative bronchopneumonia,3 but the invasiveness of the organisms is of such low degree that their entrance into the lungs and their proliferation are probably aided by other conditions. Although diminution in the ventilation of the whole lung is an important predisposing cause, it is not more marked in cases in which complications develop than

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