Abstract In presenting this subject we realize that we are adding to the already voluminous writings on pseudopathology which have accumulated through the years, and we are fully aware of the futility of any presentation which is merely an addition to the store. However, if by the presentation of certain clinical observations we can stimulate discussion and further active investigation in a field which despite the literature is still somewhat uncharted, a definite contribution will have been made. In the diagnosis of surgical conditions, acute or chronic, involving the viscera we are usually confronted with certain signs and symptoms which we consider characteristic. Pain, tenderness, nausea and vomiting, abdominal rigidity and distention comprise a chain which surgeons are prone to interpret as signifying pathologic involvement of the viscera. The fact that conditions remote from the apparent location of the disturbance—extravisceral conditions, let us say—may produce signs similar to those of pathologic References 1. Ussher, N. T.: Spinal Curvatures—Visceral Disturbances in Relation Thereto , California & West. Med. 38:423 ( (June) ) 1933. 2. Dejerine, J.: Semiologie des affections du système nerveux , Paris, Masson & Cie, 1914, p. 257. 3. Carnett, J. B.: The Simulation of Gall-Bladder Disease by Intercostal Neuralgia of the Abdominal Wall , Ann. Surg. 86:747 ( (Nov.) ) 1927 4. Chronic Pseudoappendicitis Due to Intercostal Neuralgia , Am. J. M. Sc. 174:579 ( (Nov.) ) 1927. 5. Gunther, Lewis, and Kerr, W. J.: The Radicular Syndrome in Hypertrophic Osteo-Arthritis of the Spine: An Analysis of Thirty Cases , Arch. Int. Med. 43:212 ( (Feb.) ) 1929. 6. Nielsen, J. M.: The Radicular Syndrome , J. A. M. A. 88:1623 ( (May 21) ) 1927. 7. Mayer, E. E.: Radiculitis: Its Diagnosis and Interpretation , J. A. M. A. 71:353 ( (Aug. 3) ) 1918. 8. Morley, J.: Significance of Afferent Impulses from the Skin in the Mechanism of Abdominal Pain , Lancet 2:1240 ( (Dec. 14) ) 1929. 9. Robertson, George: Disturbed Reflexes; Their Significance in Acute Abdominal Disease , Surg., Gynec. & Obst. 43:807 ( (Dec.) ) 1926. 10. Weiss, S., and Davis, D.: The Significance of Afferent Impulses from the Skin in the Mechanism of Visceral Pain , Am. J. M. Sc. 176:517 ( (Oct.) ) 1928. 11. Forbes, A.; Cannon, W. B.; O'Connor, J.; Hopkins, A. McH., and Miller, R. H.: Muscular Rigidity With and Without Sympathetic Innervation , Arch. Surg. 13:303 ( (Sept.) ) 1926. 12. Livingston, E. M.: The Skin Triangle of Appendicitis , Arch. Surg. 13:631 ( (Nov.) ) 1926. 13. Pottenger, F. M.: Important Reflex Relationships Between the Lungs and Other Viscera , J. Thoracic Surg. 1:75 ( (Oct.) ) 1931. 14. Hoover, C. F.: Diseases of the Muscles , in Tice, F.: Practice of Medicine , Hagerstown, Md., W. F. Prior Co., Inc., 1920, p. 527. 15. Pratt, J. H.; Golden, L. A., and Rosenthal, J.: The Psychalgias , J. A. M. A. 98:441 ( (Feb. 6) ) 1932. 16. Cope, Zachary: The Early Diagnosis of the Acute Abdomen , New York, Oxford University Press, 1928. 17. MacKenzie, J.: Symptoms and Their Interpretations , ed. 4, London, Shaw & Sons, Ltd., 1920.
Archives of Surgery – American Medical Association
Published: Oct 1, 1934