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Arch Surg. 1948;56(4):484-507. doi:10.1001/archsurg.1948.01240010492004.
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PLANS FOR INSTITUTING the best possible type of treatment for patients with injuries of the spinal cord and their complications can be ideally developed in centers with large wards for paraplegic patients. Such centers can be found at several army general hospitals or at numerous veterans administration hospitals in the United States. In the institutions to which these patients are now being sent for definitive treatment there exists an excellent opportunity to study injuries of the spinal cord as well as to observe the results and the merits of the various accepted technics of management.

THE PROBLEM  The patient is at first completely dependent on nursing care. On admission to the hospital he is confined to bed. He is paralyzed from his hips down. He may have no control of his rectal and urinary sphincters; he may have retention of urine and he may have several large decubitus ulcers, most


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