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Charles W. Olsen, M.D.
JAMA. 1931;97(6):391. doi:10.1001/jama.1931.27310060002009b.
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Mrs. A. S., aged 30, stenographer, nullipara, seen, Dec. 6, 1930, with a negative past medical history except a left mastoidectomy in 1922, felt perfectly well and ate a hearty supper. At 7 p. m. she was seized with a dull aching lower abdominal pain which in one and one-half hours became diffuse and with somewhat greater intensity on the right side. At 8 o'clock she became extremely faint, was pale, and was covered with a cold sweat. Physical examination at 10 o'clock was negative except for the abdomen, which was markedly distended and was tympanitic except at the sides, which were decidedly dull. Change in posture produced an increase in the dull area on the side on which the patient was lying, and a decrease in the dull area on the opposite side. The skin was cold and clammy; the expression was anxious; the eyes were staring; the pulse


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