November 16, 1963

Medical Clichés

Author Affiliations

Decatur, Ill

JAMA. 1963;186(7):733. doi:10.1001/jama.1963.03710070135020

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To the Editor:  —Scanning a few of the many current medical journals has led me to believe that there is an open season on medical clichés, especially those which confuse rather than clarify. One such cliché, well-known to the laity, is, "Turn your head to the side and cough." One sophisticated by service in the armed forces and by industrial pre-employment physical examinations will cough knowledgeably, often before an examining finger can be positioned. The cough technique can be helpful in the identification of some inguinal hernias. More frequently, however, it is inadequate and many hernias will be overlooked early in development at a time when repair is most successful.A much more effective maneuver using patient participation is the continuous application of increased intra-abdominal pressure. This is accomplished by having the patient "strain as if having a bowel movement," or by having him contract his muscles to some other

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