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W. G. Parker, M.D.
JAMA. 1919;73(21):1629-1630. doi:10.1001/jama.1919.02610470065031.
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To the Editor:  —I have read your editorial on the relationship between herpes zoster, syphilis and chickenpox. The segmental distribution and spinal findings indicate that it may have a central causative factor, as distinguished from peripheral nerve irritations. Some time ago I had a case of gallstone disease in which occurred a marked herpetic eruption over the abdomen in the region of the gallbladder. At this time the patient was suffering from repeated attacks of colic with marked jaundice, evidently due to common duct blockage. I operated on her a few days later, the jaundice having cleared up considerably, and at that time found the cystic duct obstructed by a large stone, as well as a number of stones in the gallbladder. I have no doubt that in this particular case there was so much irritation about the gallbladder neck that a "reflex irritation" brought about the external herpetic eruption


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