One of the most valuable lessons that I have learned is that extensive adhesions can result from simple intrapelvic work, without infection playing any recognized part. Several times I have had to reopen the abdomen in patients on whom I had previously performed some simple-operation, such as shortening the round ligaments, and have been amazed at the extent of the anatomic distortion found in the pelvis.
Until comparatively recently, I failed to realize the extent to which peritoneal surfaces could glue themselves together through the agency of the serous exudation that follows such simple trauma as that produced by multiple needle and volsellum puncture. The fact that simple serous exudation can terminate in vicious multiple adhesions is denied by some who believe infection to be the necessary causative factor in their production. Those who defend this view have not given the subject sufficient experimental study. Adhesions, indubitably, may follow infection;