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March 16, 1940


JAMA. 1940;114(11):964. doi:10.1001/jama.1940.02810110030015

The simulation of diseases by pseudosyndromes may confuse the clinical picture, mislead diagnosis and contribute to therapeutic error. Frequent colds, sinusitis, bronchitis and recurrent pneumonias in children are generally considered infectious and related to reservoirs of infection in the tonsils. Consequently tonsillectomy is often prescribed. According to Public Health Reports 1,235,000 tonsillectomies are performed each year in the United States. Hansel and Chang1 now point out that signs and symptoms of respiratory abnormality in the upper tract may frequently be due to an allergic factor simulating the infectious etiology discoverable in the majority of such cases. Hence the proper diagnosis of respiratory diseases centers for them in careful clinical and laboratory examinations that are based on the threefold possibility of an allergic agent, an infective agent and an allergic phase obscured by acute or chronic infections. Ultimate diagnostic determination is achieved by a differential test.

In an examination of