The symptoms of a typical attack
A clearly ordered sequence seldom lack;
The first complaint is epigastric pain
Then vomiting will follow in its train,
After a while the first sharp pain recedes
And in its place right iliac pain succeeds,
With local tenderness which thus supplies
The evidence of where the trouble lies.
Then only — and to this I pray be wise —
Then only will the temperature rise,
And as a rule the fever is but slight,
Hundred and one or some such moderate height.
‘Tis only then you get leucocytosis
Which if you like will clinch the diagnosis,
Though in my own experience I confess
I find this necessary less and less.
From Zachary Cope, The Diagnosis of the Acute Abdomen in Rhyme, 1947.