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J. R. P., a coal-passer in the U. S. Navy, aged 19, presented himself to the medical officer of the ship at 10 a. m., May 14, 1913, complaining of abdominal pain from which he had suffered since 8 p. m., May 13, 1913. He gave a history of a similar but much milder attack two months earlier. The pain began about the umbilicus but toward morning had become localized in the right iliac region.
Examination revealed a very slight rigidity of the right rectus; no tenderness low in the right iliac region; a distinct tenderness over McBurney's point and great tenderness over a small area above and external to this point. The patient had vomited once during the night. The temperature at this time was 99.2 F. The leukocyte count was 8,200. A diagnosis of acute appendicitis was made, with the prediction that the appendix would be found retrocecal.
ROSSITER PS. AN UNUSUAL COMBINATION OF CONDITIONS PRODUCING APPENDICITIS. JAMA. 1913;61(25):2240–2241. doi:10.1001/jama.1913.04350260038014
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