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JAMA Revisited
May 21, 2019

Minor Comments

JAMA. 2019;321(19):1941. doi:10.1001/jama.2018.15341

Originally Published May 21, 1904 | JAMA. 1904;42(21):1361- 1362.

Since the days of the great Piorry physicians have used the graphic method in locating accurately the outlines of certain organs in diseased conditions. Particularly in cardiac and pulmonary affections areas of dullness or adventitious sounds are mapped out on the patient’s skin by means of colored pencils. In a recent address Lannelongue1 has advocated a more extensive application of the graphic method. He claims that particularly in diseases of the joints, and to a less extent in the abdomen, the method may be of considerable value. In the case of suspected joint lesions, especially when these are in an early stage, he maps out with colored pencils the bony prominences and lines of articulation on the two sides, the two joints being held, of course, in exactly similar positions. By this means, according to Lannelongue, slight aberrations from normal which might be overlooked or misjudged are rendered much more apparent than mere palpation would make them. In the abdomen, by means of a pentagon, the angles of which occur at the pubes, the anterior superior spines, and the rib margins at the mammary lines, the author shows the situation of the various parts of the intestine and the attachment of the mesentery. The method appeals to us as one which may be of value in some cases, especially to those physicians in whom the sight is more developed than the touch.