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Gerald B. Webb, M.D.; G. Burton Gilbert, M.D.
JAMA. 1923;81(1):25. doi:10.1001/jama.1923.26510010001010.
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The occurrence in three patients of fractured ribs following a cough, and the fact that none had been recognized by good clinicians, prompt the recording of these cases.


Case 1.  Fracture of fourth and fifth left ribs. Mr. B., aged 34, with extensive pulmonary tuberculosis, was attacked with a very sharp pain in the left side following a severe nocturnal cough. The diagnosis of pleurisy was made. The side was strapped without relief. Finally, morphin had to be administered to control the pain and cough. The left lung having active disease throughout, artificial pneumothorax was attempted, but failed. As the disease was progressing, surgical collapse was decided on, and an operation was performed three weeks after the onset of the severe pain, which had persisted. To the surprise of the surgeon, two ribs, the fourth and fifth, between the internal border of the scapula and the


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