The Yakima herald. [volume] (North Yakima, W.T. [Wash.]) 1889-1914, 1912-02-21
FINDS new SIGN TO
DIAGNOSE TYPHOID
Pressure on Biceps Produces Ridge
Duration of Which Indicates
the Virulence

NEW YORK, Feb. 16.-Dr. Chas.
Bernard Burke, of Atlantic, Iowa, de-
scribes in the New York Medical Jour-
nal a new diagnostic reflex sign in
! typhoid fever which, he believes, is of
great value in determining the pres
ence or absence of that disease. He
| describes and comments upon it as
follows:
THE sign to which I wish to call
your attention, so far as l am aware,
has not been described previously. My
search of the literature has been con-
| fined to standard works on typhoid
fever, textbooks on the practice of
medicine and a large number of
medical journals. l believe that l am
justified in offering this sign to the
medical profession, because it is an
independent manifestation, elected in
a definite way, and is capable of af-
fording diagnostic evidence of impor-
t. nee; it does not occur in health or
| in haphazard technique too complicat-
ed for routine application.
Contraction of Muscle
1.-The arm of the patient is barred
| to the shoulder. You arch your
| of a horseshoe and place them over
the biceps muscles of the arm, so that
the arch thus formed is completely
| filled; then firm pressure is made by
the finger and thumb, and the hand
is briskly raised (pressure being con-
tinued) SO that the thumb and finger
come together with a slight concus-
sion. The result, if the reflex is
present, is a fbrillary contraction of
| that portion of the biceps muscles
traversed by the thumb and finger,
| producing an oval ridge without COM
| plete contraction of the biceps muscle.
| The ridge thus formed disappear RS
| slowly.
After applying the test in rather
large number of cases of different dis
eases during my service in st. Jo-
sephs hospital, Joliet. ILL.,, and having
been allowed through the courtesy of
the attending physicians of Atlantic
hospital to apply the test in a mum
Der of their cases, | have come to
the conslusion: If the reflex describ-
| ed is absent there Is no typhoid fever
present.
This conclusion is based on the
| fact that / never found a case of
| typhoid fever that showed the Vidal
| reaction or bacillus typhosus in the
blood that did not show this reflex
also. 1t is true that / found this
| sign in other diseases, but that is true
of nearly all signs / imagin that
the absence OF this reflex in diseases
stimulating typhoid fever may be a
N vi at 1.
agnosis.
May Aid in PrOgnosis
81 have observed that this reflex
seems to be governed by the virulence
of the Infection; that is, at the be-
ginning of the disease the oval ridge
| is not so pronounced, nor does it per-
sist as long as it does at the height of
| the fever 1t is also true that the
more pronounced and the more per-
| sistent the reflex. SO | think it may
be some aid in making a prognosis
II am unable to say just how early
| this reflex may be ELECTED, for every
| case l examined was late in the first
week or early in the second. The
| typhoid fever cases recorded in the
table were verified either by the Vidal
iaNtioI VI ny HHohhS the typHolu pa
| cillus in the blood.
ut is probably due to an irritation
of the peripheral nerves, caused by
| some toxic agent. The toxine elabor-
/ ated by the typhoid bacillus has a
| selectiNe property for nerve tissue
and may act AS direct irritant to
the periphers1 nerves, thus causing
| the reflex when irritated by the
thumb and hnger."