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Arch Surg. 1943;46(5):611-613. doi:10.1001/archsurg.1943.01220110027007.
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"Menstrual cramps and backache" have persistently played a prominent role among the chronic complaints that periodically interfere with feminine activities. Numerous investigations, in a search for causes and cures, have left a variety of theories which have obscured the factors involved.1 By the use of fundamental methods of physical diagnosis, accurately applied, certain pertinent factors not heretofore generally recognized have been brought to light concerning dysmenorrhea.

In the examination at the time the complaints are present it can be noted that:

1. The localization of the pain of "abdominal cramps" is along the twelfth dorsal or the first lumbar spinal nerves or both, or along their branches, the ilioinguinal and iliohypogastric nerves, or along all these. Hence the symptoms are localized in relation to the peripheral nerves in the abdominal wall and not in relation to intrapelvic structures.2

2. The localization of the pain in the back is


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