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Leonard A. West, M.D.
JAMA. 1922;79(24):1998. doi:10.1001/jama.1922.26420240003013c.
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A blacksmith, aged 48, entered the hospital, July 13, 1922, complaining of pain in the abdomen. Several days before admission, he developed a sharp pain, intermittent in character, over the entire abdomen at first, and later localizing in the right iliac region. There was no nausea or vomiting. The pain was not affected by, nor had it any relation to, the taking of food. Since the onset, the patient had had a gradual increase in frequency of urination, until, at the time of admission, he had a marked daily frequency and urinated five or six times at night. His temperature and pulse were normal on admission, and the leukocyte count was 6,300.

The previous history was negative. The patient had not missed a day from his work on account of sickness in the past thirty years. The physical examination was negative except that there were many abscessed teeth and marked


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