A hundred years ago: Pitfalls in the diagnosis of appendicitis. Practitioner 2015–259 (1787): 33

Pitfalls in the diagnosis of appendicitis

25 Nov 2015Registered users

When you get gangrene like that, the local symptoms are, very often almost absent; the abdomen may move quite freely, there may be no rigidity, there may not be any pain on pressure, and the temperature is not necessarily raised. The pulse, however, is always quicker. When the pulse is increased, there is a case for operating early. If high, you must operate, whatever else happens. I can recall cases in which, because there were no marked symptoms, and because attention was not paid to the pulse, the patient was allowed to go on for over a week, carefully watched with a masterly inactivity.

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