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Nathan Flaxman, M.D.
JAMA. 1935;105(5):384. doi:10.1001/jama.1935.02760310058026.
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To the Editor:—  In the article by Wakefield, Mayo and Bargen entitled "Ileus Associated With Transient Renal Insufficiency: A True Enterorenal Syndrome" (The Journal, June 22, p. 2235) there appears to be no mention of stethoscopic examination and sounds heard over the abdomen in any one of the ten cases reported. It is very likely that such an examination was performed in each case for audible peristaltic sounds and was very likely absent in all, so that it was omitted in the report. The importance of listening for peristaltic sounds in the differential diagnosis of paralytic and mechanical ileus was deeply impressed on me by Dr. Roger T. Vaughan at the Cook County Hospital whenever the problem presented itself. Especially is this of value when the patient has had one or more previous abdominal operations. Dr. Vaughan insisted, and probably still does, that one listen with the stethoscope over each


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