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May 8, 1909


JAMA. 1909;LII(19):1492. doi:10.1001/jama.1909.25420450024002b

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The following cases appear of sufficient interest to warrant record as illustrating instructively two weak points in the practice of surgical diagnosis: (1) The easy thoughtlessness with which the ordinarily wide-awake surgeon falls into the habit of either allowing the patient to make his own diagnosis or of carelessly perpetuating the diagnostic errors of his predecessors; (2) the willingness with which the average surgeon accepts the doctrine of "traumatic" hernia, without ever so much as considering the possibility of error in the diagnosis of either hernia or trauma.

Case 1.—History.  —A. B., aged 28, railroad station helper, a tall, lanky, unhealthful looking countryman with indefinite family history; while between a heavy baggage cart and a train, was contused in the left groin and back. There was moderate disturbance in both regions, with no important objective symptoms, and he remained at home for three days. In about four weeks he

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