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INFANTILE PYLORIC OBSTRUCTION:  PRELIMINARY REPORT OF ITS ALLERGIC NATURE

MILTON B. COHEN, M.D.; JOSEPH BREITBART, M.D.
Am J Dis Child. 1929;38(4):741-745. doi:10.1001/archpedi.1929.01930100061007.
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In spite of much clinical observation, infantile pylorospasm and pyloric stenosis remain obscure in etiology and in their relationship to each other. Those observers who claim to be able to differentiate between them clinically, by roentgen examination or by both methods, are frequently proved wrong by the clinical course, at operation or at autopsy. Most clinicians include patients with both conditions in the classification of hypertonic infants, since general muscular hypertonus occurs with great frequency in them. Ward,1 who reviewed this subject in 1927, inferred that the only way to differentiate between them is by the end-result. If, on the administration of atropine and on a thick diet, the child improves, the case is one of pylorospasm; if no improvement follows these measures or if the symptoms continue to grow worse despite them, a diagnosis of organic obstruction is made and operation is advised. At operation a firm muscular

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