JAMA. 1914;LXII(17):1321-1322. doi:10.1001/jama.1914.02560420027012.
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The splenic flexure marks an intermediate position in the colon both anatomically and physiologically. The proximal segment, the cecum and the ascending and transverse colon, as observed by Cannon,1 churn and mix the bowel contents until the moisture is largely removed. Starling2 has compared this process with the contractions in the pyloric end of the stomach. The dry part of the intestinal mass begins to collect, therefore, at the splenic flexure, where there is frequently a sharp angulation in the colonic tract. This abrupt change in the course of the bowel causes a hindrance to the passage of its contents, resulting in one of the pressure-points in the colon. The predisposing causes of carcinoma, ulceration and chronic irritation exist here, no doubt, as in regions in which cancer is more frequent. A routine examination of this territory when the abdomen is opened reveals the fact that the costocolic


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