Abstract
In the brief limits allowed to this paper, among so many others, it is impossible to discuss more than the treatment of perforation of the bowel in typhoid fever. The diagnosis of this serious complication, which is equally, if not more, important, must, unfortunately, be omitted. What I have to say may, perhaps, be best stated in answer to four questions. 1.Shall we operate at all?This question can now be answered absolutely in the affirmative. Thirteen years ago, when Prof. James C. Wilson and I first discussed the advisability of operation in a case of apparent typhoid perforation, not a single case had been operated on in America, and only one in Europe, by Mikulicz, and of this we were ignorant. Then, the question was debatable; now, experience has given us a positive solution. In my book on the "Surgical Complications and Sequels of Typhoid Fever," published early

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