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Article
December 27, 1919

THE DIAGNOSIS OF CHRONIC CHOLECYSTITIS COMPLICATING CARDIAC LESIONS

JAMA. 1919;73(26):1929-1932. doi:10.1001/jama.1919.02610520019010
Abstract

Although I do not wish to reflect invidiously on the judgment of other practitioners, still I think I am not making an extreme statement when I say that there is a tendency among some physicians to attribute to. a discovered cardiac lesion most, if not all, of the symptoms of which the patient complains. This is illustrated by precordial pain. If opinion is sought by the patient because of pain in the region of the heart, and if the physician recognizes the existence of a valvular defect, for instance, the symptom is likely to be attributed to the heart and treatment instituted accordingly. If the pain is evoked or intensified by exercise, this is considered proof positive of the correctness of the conclusion, and the patient may be ordered to bed or at least told to keep quiet. Soreness of the pectoral muscles or tenderness of the intercostal nerves may

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