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JAMA. 1918;71(4):283. doi:10.1001/jama.1918.02600300047013.
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The recent communication by Peet1 in The Journal, relating to the subject of catharsis before surgical operations, supplements the contentions of Alvarez2 of the Hooper Foundation for Medical Research that purgation as a routine preoperative procedure should be abolished. In his studies on the intestine, Alvarez had noted that after vigorous catharsis the isolated musculature is no longer as responsive as normally to stimuli and is fatigued with greater readiness. The bowel as a whole may become unduly filled with gas and fluid, the circulation of the intestine somewhat impaired, and the peristalsis deviated from its usual manifestations. In this way it was believed that much of the gas distention, postoperative ileus, and perhaps the nausea and vomiting may be partially accounted for in patients who have undergone surgical operations.

Peet has accentuated the difficulty thus encountered by asking what is expected to be gained through the preparatory


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