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Harrison, Ark., Aug. 23, 1902.
To the Editor:
—After examining a patient with most of the ordinary objective and subjective symptoms of appendicitis— tumefaction, muscular rigidity, fever, pain and cutaneous hyperesthesia—the physician is often still in doubt whether the case is or is not one of appendicitis. In just such cases, indeed in all cases, for the last two years I have learned to depend very materially on the following plan to aid in the diagnosis: Have the patient lie on the back, with the legs flexed on the thighs, the thighs flexed, the feet resting evenly on the bed, the lower limbs held or steadied in this position by an assistant. Then place the tip of one finger on the skin of the abdomen over the seat of greatest tenderness—usually McBurney's point—press down slowly with about as much force as the patient will tolerate. Still keep up this pressure
Ki[ill]by L. An Aid to the Diagnosis of Appendicitis. JAMA. 1902;XXXIX(9):501. doi:10.1001/jama.1902.02480350039012
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