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April 23, 1927


Author Affiliations

Professor of Gynecology, New York Post-Graduate Medical School and Hospital NEW YORK

JAMA. 1927;88(17):1302-1305. doi:10.1001/jama.1927.02680430004003

The art and the science of medicine advance by a process of slow evolution. While it is true that the research worker occasionally makes a discovery that materially alters our conception of a diagnostic or a therapeutic problem, as a rule the clinician is compelled to rely on his personal observations, intellectual exercise, and a study of the current literature for his own professional progress.

Even in the light of past experience, ectopic gestation always taxes our diagnostic resources and surgical judgment. Its etiology seems mysterious; it is not characterized by pathognomonic symptoms; the differential diagnosis is difficult, and its immediate treatment often a matter of debate. Except for acute appendicitis, it supplies the operating table with more emergent and tragic cases than any other lesion of the lower abdomen. I have attempted a graphic portrayal of the different types of clinical problems, in an effort to elucidate the underlying

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