Blood Bath

A careful surgeon would no more neglect to drain off escaped blood while operating in the peritoneal cavity than he would operate with unsterilized instruments. He believes that drainage helps keep the cavity clean, lessens risk of peritonitis. But peritonitis often develops after "dry" operations nevertheless.

During the Arab-Jewish riots of 1936 in Jerusalem, Dr. Edward G. Joseph of Hadassah Hospital had many a patient whose abdomen was badly shot up. Dr. Joseph did not resort to drainage. Instead, he operated in a blood bath, stitched up his patients' intestines, closed their abdomens without further ado. When the victims recovered like clockwork, with no hint of peritonitis, he decided that free outpouring of blood in the peritoneal cavity might be more help than harm.

Dr. Joseph tried out his theory on dogs and rabbits, then further on humans. Last week the Lancet summarized his findings. When he soiled the peritoneum without allowing bleeding, during an operation on the colon, eleven out of twelve animals developed peritonitis. When fresh blood was injected into the cavity, only one in four became infected and adhesions were notably few. On human patients 200 cc. of blood run through a tube into the abdominal cavity at the end of the operation produced favorable recoveries.

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