Arch Surg. 1940;40(6):1176-1184. doi:10.1001/archsurg.1940.04080050139012.
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The central nervous system differs from other portions of the body in a number of anatomicophysiologic factors which give rise to therapeutic (as well as diagnostic) problems encountered in no other field of surgery. For example, the direct influence of the central nervous system on every organ and part of the body may produce indications for therapy in many portions of the body remote from the central nervous system itself. Further, the position of the central nervous system within the rigid skull and vertebral column not only gives rise to special physiologic problems but makes surgical exposure of the brain or spinal cord and subsequent closure of the wound long, arduous and painstaking tasks.

Such factors, among many others, produce special preoperative and postoperative difficulties which are encountered infrequently, if at all, in other surgical fields. The most thorough diagnostic study and the most brilliant operation may be to no


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