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December 4, 1948

The Mechanism of Abdominal Pain

JAMA. 1948;138(14):1066. doi:10.1001/jama.1948.02900140058031

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This book, divided into twenty-two chapters, deals with the subject of abdominal pain. Interspersed in the first chapter, pertaining to historical data, are some interesting anatomic plates starting with the time of Vesalius. Basing his opinion on clinical evidence—namely, patients with transverse lesions of the spinal cord—Kinsella is of the opinion that some pain fibers from the abdominal viscera probably ascend in the sympathetic trunk, but not in the vagus. The author emphasizes the limitations of animal experimentation and prefers to make his observations in man during operations with the patient under local anesthesia.

He stresses the belief that if a viscus is cut or clamped no pain results because few nerve fibers are present; however, if the vascular part of the mesentery is cut or clamped pain results because of the great number of fibers which are present and stimulated. The subject of muscular rigidity is discussed; however, this

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