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To the Editor:
—Textbooks and literature on appendicitis have laid so much emphasis on rigidity of the right rectus muscle as a symptom, that many cases of appendicitis have been neglected, because of lack of rigidity of the right rectus muscle. Rigidity of the right rectus, we all agree, is the most reliable of the symptoms which we have in appendicitis. There are a few cases, however, in which rigidity of the right rectus is lacking, but if looked for, there will be found rigidity of the right external oblique muscle. The cases of rigidity of the right external oblique muscle, and absence of rigidity of the right rectus, pursue a peculiar course. All cases are considered mild, many patients are up and around, some attending to business, and only a high polynuclear count shows the seriousness of the disease. In over twenty cases seen the past year, in which
Randall HE. Rigidity of the Right External Oblique in Appendicitis. JAMA. 1915;LXIV(23):1931. doi:10.1001/jama.1915.02570490047028