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To the Editor:—
One of the common complaints heard in medical and surgical practice is concomitant pain in the abdomen and back. About 1915, when the three most important trunk disorders of orthopedic interest were tuberculosis of the spine, osteoarthritis, and malignant disease, Dr. John Lincoln Porter taught me a simple rule that has proved valuable in many cases: If the level of the pain is the same in the abdomen and back, its origin is probably in the former, and, if the level of the pain is lower in the abdomen than in the back, its origin is probably in the latter.
Lewin P. CONCOMITANT PAIN IN THE BACK AND ABDOMEN. JAMA. 1956;160(14):1257. doi:10.1001/jama.1956.02960490071020