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July 1923


Author Affiliations

Adjunct Assistant Visiting Surgeon, Bellevue Hospital NEW YORK
From the Third Surgical Division of Bellevue Hospital and the Department of Experimental Surgery, New York University and Bellevue Hospital Medical College.

Arch Surg. 1923;7(1):83-95. doi:10.1001/archsurg.1923.01120010086005

The viscerosensory phenomena are altered responses to stimuli, applied to the superficial structures of the body wall; these altered responses being caused by acute diseases of certain internal organs. Such manifestations are referred to, in this article, as skin signs. The explanation of these phenomena is difficult. The presence of an acute disease within a viscus causes afferent impulses, which pass through the paravertebral ganglions (thoracicolumbar outflow of the autonomic system), reaching the spinal cord through the posterior root ganglions of the central nervous system and passing thence to the brain, as shown in Figure 1. Within the spinal cord and the sensory ganglions, the fibers carrying these impulses lie in close proximity to, or synaptic relation with, the central endings of sensory fibers originating in the body wall. During an acute disease within a viscus, the patient may—because of this central connection of visceral afferent fibers with sensory fibers

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