IN A LARGE general hospital with an insufficient number of pediatric surgical cases to warrant a full-time specialist in this field, the policy with reference to surgery in children may be somewhat problematical. Should pediatrics surgery be performed by all general surgeons or should it be on an assignment basis? The ordinary run of appendectomies and herniorrhaphies in children would seem to be adequately handled by the average general surgeon. However, in conditions where the preoperative and postoperative care is more involved, even though the surgery be uncomplicated, the average surgical service may find the ground so unfamiliar that suboptimal conditions prevail. A common condition of infants exemplifying the questions involved is congenital hypertrophic pyloric stenosis.
Prior to Dec. 1, 1949, the surgery of children at the Boston City Hospital was performed by several different general surgeons on two different surgical services. At this time, in an effort to improve