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M. W. Lyon Jr.
JAMA. 1920;74(1):48. doi:10.1001/jama.1920.02620010053028.
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Dr. Spillman's letter was referred to Dr. Lyon who replies:

To the Editor:  —Dr. Spillman's chief argument for the employment of "acute abdomen" seems to be that it has the sanction of Dr. Charles L. Gibson, an undoubted purist as shown by several examples. The fact that Dr. Gibson uses the term within quotation marks is an admission that the expression is irregular. I see no special objection to using it with quotation marks. Like "T. B. bugs," "beasts" as applied to protozoa, and "shots" of bacterins, such expressions as "acute abdomen, acute appendix, chronic appendix," etc., would be better confined to familiar conversations than be used in formal speech or publication.The Century Dictionary defines acute as follows: "1. Sharp at the end;... 2. Sharp or penetrating in intellect;... 3. Manifesting intellectual keenness or penetration;... 4. Having nice or quick sensibility;... 5. Keen; sharp; intense; poignant: said of pain,


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