Ernst Trömner: beyond the reflex hammer.

Ernst Trömner (1868-1930) was a German neurologist and psychiatrist at the St. Georg Hospital in Hamburg. As clinician and researcher, he contributed to our understanding of various fields within neurology including language and speech disorders, hypnosis and suggestion, sleep physiology and diseases, leukemia with nervous system involvement, gait disorders, metabolic myelopathy, Parkinson's disease, organic psychosis, and schizophrenia. However, his main interest was muscle reflexes. De facto, Trömner described a variant of the Achilles tendon reflex, a modification of the Oppenheim's and Babinski's reflexes, "rediscovered" the corneomandibular reflex and described the joint reflexes of the lower extremities as well as a muscle stretch reflex of the diaphragm. Moreover, Trömner has developed the first sedimentation chamber to assess the cerebrospinal fluid as well as the muscle plessimeter and, probably most considerable, the reflex hammer which is widely used by neurologists around the globe to date and is commonly referred to as the "Trömner hammer." His name has also become inextricably linked with the finger flexor reflex, which is commonly known as the "Trömner reflex." This article briefly summarizes Professor Ernst Trömner's life and his contributions to clinical neurology and psychiatry beyond his most famous eponyms, the hammer and the finger flexor reflex.

A historical account of the doctor's bag.

BACKGROUND: A household phrase of yesteryear was the doctor's 'little black bag'. Where did this phrase come from and how did it evolve? OBJECTIVE: The objective of the article is to outline the history of the medical bag and its contents, from early times to the present day, by using library research methodology. DISCUSSION: The first mention of a medical bag is in the Hippocratic Corpus around 350 BCE. This demonstrates that since ancient times, medical practitioners have carried some equipment and medications with them when they visited their patients, the exact contents changing over time.

Benjamin Terry and his rapid razor section method for intraoperative diagnosis.

Benjamin Taylor Terry (1876-1955), a little-known pathologist, played a critical role in the popularization of intraoperative diagnostic techniques in the 1920s and 1930s. He developed both a stain and his own rapid razor section method. Intraoperative diagnostic techniques were ultimately responsible for the transition of the practice of pathology and laboratory medicine from private commercial laboratories to a hospital-based practice, forever changing the history of pathology and surgery in North America. Although the intraoperative diagnostic technique he personally developed was reportedly better, faster and more economical than frozen sections, the latter ultimately won the battle for intraoperative diagnostic supremacy.

Nineteenth-century contributions to the mechanical recording of postural sway.

In the first half of the 19th century, European physicians, including Marshall Hall, Bernardus Brach, and Moritz Romberg, described loss of postural control in darkness by patients with severely compromised proprioception. Late 19th-century neurologists developed instruments to measure and record postural sway in patients with neurologic disease. Principal American contributors were the neurologist Silas Weir Mitchell from Philadelphia, Pa, and his trainees Morris Lewis and Guy Hinsdale. The efforts of these neurologists anticipated later physiologic studies and ultimately the development of computerized dynamic platform posturography.

[Taking a look at the characteristics of the diagnostic methods of Traditional Chinese Medicine (TCM) from the periodical literature in the republican period of China].

Compiling 198 pieces of literature related to TCM diagnostic method in 210 kinds of medical periodicals during the republican period of China, they can be divided into three categories by different characteristics: theoretical research, popular common sense, works and lectures etc. Taking a look at the contents of the articles, there were 74 pieces of comprehensive literature (37%) 20 pieces of inspection literatures (10%) 6 pieces of auscultation and olefaction literature (3%) 11 pieces of inquiry literature (6%) 87 pieces of palpation literature (44%) Pulse diagnosis is a traditional distinguishing diagnostic method which involves much research. The literature on pulse diagnosis was in the majority The articles about theoretical research mostly explained the TCM principles with western medical knowledge and advocated diagnosing the disease with western medical apparatus, which was the characteristic of that time.

[The importation of the first X-ray diagnostic machine in China].

There are different opinions and controversies about the first importation of X - ray diagnostic machine, which was imported into China. Dian shi zhai hua bao (Pictorial of Dianshizhai), based on new historical materials, reported that Boxi Hospital of Suzhou imported the X - ray diagnosed machine before the last ten day of December, 1897.

Un microscopio proyector en el recuerdo de un estudiante / A projecting microscope in the memory of a dental student

Este artículo describe un microscopio que proyectaba preparados de histología sobre una pantalla, utilizando una fuente luminosa de gran intensidad por el arco voltaico.

Origins of the sensory examination in neurology.

Formal testing of sensation as part of the neurological examination followed the improvements in examination techniques as well as advances in neuroscience. By the 1890s, the observation that temperature sense was frequently impaired at the same time that pain was appreciated led to the supposition that the two paths traveled closely. Through the works of Brown-Séquard and Edinger the existence of a crossed afferent tract was verified. The distinction between two sensory pathways was clear by 1898, when van Gehuchten reported a case of syringomyelia and suggested that the pain and temperature fibers were carried anterolaterally and the position sense fibers carried posteriorly in the spinal cord. Many authors describing patients with tabes dorsalis suspected the posterior columns of the spinal cord played a key role in position sense. It is difficult to determine in the 19th century who first employed the use of movements of joints as a test for proprioceptive function; however, Bell in 1826 recognized what he termed a sixth sense, which later was characterized as proprioceptive function. Goldscheider went on to report the degrees of movement that were considered normal for each joint. Although vibratory sense had been described by Cardano and Ingrassia in the 16th century and tests had been developed by Rinne and Rumpf by the 19th century, it was not until 1903 that Rydel and Seiffer found that vibratory sense and proprioceptive sense were closely related and that both senses were carried in the posterior columns of the spinal cord. By 1955, the sensory examination included tests for light-touch, superficial pain, temperature, position sense, vibration, muscle (deep pain), and two-point discrimination. Tests for these sensibilities still remain in use. We will review the origins of the understanding of sensation, which ultimately led to the development of the sensory examination. We will highlight individuals who made important discoveries and observations, as well as review the history of each of the elements of the sensory examination.

The Romberg sign and early instruments for measuring postural sway.

In the first half of the 19th century, European physicians-including Marshall Hall, Moritz Romberg, and Bernardus Brach-described loss of postural control in darkness of patients with severely compromised proprioception. Romberg and Brach emphasized the relationship between this sign and tabes dorsalis. Later, other neurologists evaluated the phenomenon, which is now known as Romberg's sign, in a broader range of neurologic disorders using a variety of simple but increasingly precise and sensitive clinical tests. In the late 19th century, neurologists also developed instruments to measure and record postural sway in patients with neurologic disease. Principal contributors included Philadelphia neurologist Silas Weir Mitchell and his trainees Morris Lewis and Guy Hinsdale. The efforts of these neurologists anticipated later physiologic studies and ultimately the development of computerized dynamic platform posturography.