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Medical History (continued)
Physicians being resourceful, they added many useful features such as a handle that might conceal a pin or a brush for test- ing sensation, a tool for eliciting the Babinski reflex, or even a tongue depressor! A design introduced in 1894 by William Christopher Krauss (1863-1909) was crafted of metal with a handle of hard rubber that could be heated by friction to test for thermal sensation. Another model incorporates a tuning fork as a handle.
One hammer introduced in 1910 by Ernst L. O. Troem- ner (1868-1930) of Hamburg, Germany was later adopted as the standard reflex hammer among neurologists at the Mayo Clinic. It has a metal handle and two striking surfaces of hard rubber of different diameters.
A hammer preferred by the well-known French neurologist Joseph Francois Babinski (1857-1932) consisted of a slender metal handle terminating in a metal disc with rubber rim ori- ented at a right angle to the handle. This design was modified by the American Abraham Rabiner (1892-1986) by providing an adjustable attachment of the striking disc either parallel or
perpendicular to the handle. The resulting model has been called, appropriately, the Babinski/Rabiner hammer.
The Queen Square hammer has been attributed to Miss Wintle, a nurse at the National Hospital for Nervous Dis- eases at Queen’s Square, London. Miss Wintle is said to have devised the design by applying a ring pessary to a brass disc mounted on a bamboo handle. She allegedly made and sold these devises herself beginning around 1925.
Some recent models for pediatric use feature bright colors and even may be disguised as a toy, as in the Pedia Pals brand model that resembles a giraffe. See Figure 2.
If Peter, Paul, and Mary had had a hammer, they sing that they would “hammer out danger ... hammer out a warning” and “hammer out love between my brothers and my sisters all over this land.” These goals might have been overly ambi- tious, but had they really had a hammer – and an introduc- tory knowledge of neurology – they surely would have enjoyed testing each other’s patellar reflexes.
Figure 1.
A) Taylor, B) Troemner, C) Babinski/Rabiner, D) Krauss, E) Buck (with pin and brush stored inside handle), F) Queen’s Square.
Adapted from Disserol et. al.: Arq Neuropsiquiatr, 2023 Apr; 81 (4): 340-344, Fig. 2.
HCMA BULLETIN, Vol 70, No. 1 – Summer 2024
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