Fowler's Position

tioned into such an unquestioning acceptance of its efficacy that it has now attained the status of a medical dogma, the denial of which is tantamount to the gravest charges of irresponsibility or even damnable heresy. Nevertheless there has been some recent criticism of the position, mostly of an indirect nature, and concerned with its harmful side-effects rather than with the central thesis of the prevention of subphrenic abscess. ' As a result of much recent work, notably by Homans (1934) and de Takats (1945) in America, and Rossle (1937) and Neumann (1939) in Germany, it is now established that postoperative thrombosis is much more common than was formerly believed, and that it usually starts in the deep veins of the calf or the sole of the foot and not in the iliac or femoral vessels