. The diagnosis and treatment of diseases of women. fact, these designationsare the ones commonly used inconversation among physiciansin describing the location of amass or area of tenderness. Forexample, we speak of tendernessin the right lower region of theabdomen, or more briefly, in theright lower abdomen, or inthe left lower abdomen, or inthe right upper abdomen, each of these principal regions, there are one or more points which are ofspecial interest. The special interest attaches to each one of these points, becausewell defined tenderness limited to such point usually means
. The diagnosis and treatment of diseases of women. fact, these designationsare the ones commonly used inconversation among physiciansin describing the location of amass or area of tenderness. Forexample, we speak of tendernessin the right lower region of theabdomen, or more briefly, in theright lower abdomen, or inthe left lower abdomen, or inthe right upper abdomen, each of these principal regions, there are one or more points which are ofspecial interest. The special interest attaches to each one of these points, becausewell defined tenderness limited to such point usually means an affection of a partic-ular organ. It must be kept in mind, however, that in some cases such point-ten-derness is due to an affection of some adjacent organ (as when inflammation withinthe caecum causes tenderness in the appendix region) or even of some distant organwhich has become displaced (as when the right kidney has become displaced intothe appendix region). Again, in some cases, tenderness is due to an organic or functional disturbance of. Fig. 27. The abdominal surface divided into Quadrants. REGIONS OF THE ABDOMEN 21 the nerves of the abdominal wall or to reflected pain, due to a lesion in some otherpart of the abdominal cavity or to some organic or functional lesion in a distant partof the body. But even in these exceptional conditions, the tenderness is usuallynot a genuine point tenderness, but is more extensive and can be traced in somedirection sufRciently far to indicate its probable origin. With the exceptions above mentioned kept in mind, the special areas of pointtenderness are of great help in the differential diagnosis of abdominal lesions. I do not approve of themethod of naming the princi-pal, or jDrimary, regions of theabdomen from the significantpoint-tenderness situatedtherein. For example, to de-signate the right lower ab-domen as the appendicealregion, as is done by someauthorities, leads only to con-fusion. It is no more the ap-pendiceal region tha
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