HERTZLER studied the peritoneum for many years and came to the conclusion that to prevent adhesions is to prevent healing. However, numerous investigators have utilized every imaginable modality, physical and chemical, to control the pathologic effects of adhesions. Many of the methods of procedure have been impractical and the results controversial.
In recent years, Ochsner and others experimented with digestive enzymes such as papain, claiming reduction in postoperative complications due to adhesions. Yardumia and Cooper advocated the use of pepsin intraperitoneally for the same purpose. Other digestants such as trypsin have also been tried.
The utilization of amniotic fluid concentrate (i. e., amfetin) as a stimulator of the peritoneal defense mechanism was investigated by Johnson, Warren, Lacy, Rea and Wangensteen, and favorable reports were published. Larson and Halverson introduced sodium ricinoleate as a peritoneal stimulant. Bargen, Judd, Waldron and Steinberg proposed peritoneal immunization with killed vaccine suspensions of Escherichia coli. Seeley later