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Downgoing toe on the Babinski test
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meaningless unless one knows that the extensor muscle of the big toe is capable of function
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  • Critchley's chapter on the Babinski reflex describes many interesting facets of the assault on the big toe:
    • "When perusing the literature, he [Babinski] would make critical notes in the margin of the book. He could not tolerate confused, obscure, or imprecise writings, the product of what he called the chieurs d'encre, which may be translated as `ink shits.'" [p. 33]

    • "During the nineteenth century neurologists had often tickled the soles of their patients' feet, noting merely whether there was a prompt or a sluggish reactionary movement of the toes." [p. 33] Babinski, however, was the first to take note of the direction the toes moved. Comptes Rendus de la Société de Biologie, 22 February 1896.

    • "A blunter implement [than a sharp pin] is just as efficacious [for eliciting the Babinski sign], without necessarily agreeing with Dr. Henry Miller that the ideal is the car key of a three-litre Bentley." [p. 36]

    • "As might be expected, the success of Babinski's clinical discovery led to a multitude of lesser mortals trailing on his coat-tails as though he were the Pied Piper of neurology. These camp followers fall into two groups. First there are those who contrived to bring about an extension of the great toe by other manoeuvres. ... There were those, like Chaddock, who stroked the outer side of the dorsum. Others, like Gordon, firmly squeezed the calf. Oppenheim heavily rubbed the shinbone from above downwards. Trömers would have us press hard on the thigh muscles, and in Brazil Austregesilo was pinching the tendo Achilles. ... The other group,... especially in France, frenetically scratched, stroked, pinched, stimulated, or tickled this part of the anatomy or that -- the palm, the fingers, the glabella -- in search of some response which might bring them eponymous notoriety." [p. 36] [101]
    Footnotes in Print Edition[Top] [Nav]
    (-) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 46-1979.
  N Engl J Med 1979 Nov 15;301(20):1104-11.  Pubmed  Similars
    New References[Top] [Nav]
    101.The Citadel of the Senses.
  Critchley M. New York: Raven, 1985: 277 pp..   Amazon.com
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    ©1986-2000 John Sotos, MD. All rights reserved.  Last updated 16:34 PDT on July 4, 2000.[Top]

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