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August 1935


Author Affiliations


From the Department of Experimental Neurology, D. J. McCarthy Foundation and Department of Medicine, Temple University Medical School.

Arch Intern Med (Chic). 1935;56(2):327-340. doi:10.1001/archinte.1935.03920020119007

The differential diagnosis of visceral diseases is often aided by a study of the associated referred pain of the hyperalgetic zones of the skin and the tender areas of the muscles. Such a study, however, fails in many cases because the subjective complaints of the patients may be unreliable. It is desirable in such cases to localize pain by objective methods. It is known from the work of Head1 and of MacKenzie2 that diseases of visceral organs produce many reflexes in the skin, such as viscerovasomotor and visceropilomotor reflexes. There are also segmental reflexes from the viscera which cause localized hypertonicity of certain muscles, the so-called visceromotor reflexes. These phenomena are of clinical importance; however, they are not always found. A more delicate objective method for the demonstration of referred pain in cases of visceral disease seems therefore to be desirable.

In such cases the segments of the