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December 15, 1917


JAMA. 1917;LXIX(24):2036-2037. doi:10.1001/jama.1917.25910510003012b

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About an inch and a half to the right of the navel and a trifle caudad, one will find on deep pressure a hypersensitive point in cases of chronic appendicitis of one of the four chief kinds. This tender point does not belong to cases of acute appendicitis. It does not belong to cases of pelvic irritation or infection, except in company with a similar tender point to the left of the navel. This tender point to the right of the navel will serve to give differential diagnosis between cases of chronic appendicitis and various pelvic irritations or infections.

Why does not this tender point to the right of the navel belong to acute appendicitis? Why does it not belong to right-side pelvic disturbances? In order to answer these questions, we must inquire into the nature of the tender point. At that site we shall find the right lumbar sympathetic

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