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July 13, 1907


Author Affiliations

Adjunct Professor of Medicine, University of Buffalo. BUFFALO, N. Y.

JAMA. 1907;XLIX(2):126-128. doi:10.1001/jama.1907.25320020030001i

Acute pleuritis is sometimes accompanied by pain referred to the hypochondriac region of the affected side, and a peculiarity of the pain is its constancy. It is not felt merely on deep breathing, nor more severely on inspiration, as is so commonly the case with pleuritic pain in the nipple region. Exertion and cough, however, are prone to accentuate it, and it may cause more or less grunting respiration. I recall one case of severe epigastric pain caused by diaphragmatic pleuritis in which cough was absent, and in such a case it is difficult to arrive at a diagnosis at the onset of the disease, time and developments being necessary to determine the real nature of the affection. The abdominal pain that is present in some cases of lobar penumonia, however, is particularly striking in its deceptive characteristics. Last autumn I observed two cases in which the onset of the

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