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April 3, 1943

TWO CLINICALLY USEFUL SIGNS: 1. THE WHISTLE-SMILE REFLEX IN THE PARKINSONIAN SYNDROME 2. THE 'NEPHRITIC STARE'' IN CHRONIC NEPHRITIS

Author Affiliations

Florence McAlister Professor of Medicine, Duke University School of Medicine Durham, N. C.

From the Department of Medicine, Duke University School of Medicine.

JAMA. 1943;121(14):1152-1153. doi:10.1001/jama.1943.62840140003007a
Abstract

1. When the normal individual is requested to whistle he does so and then smiles, probably as a mimetic response to the absurdity of unmotivated whistling. The patient suffering from the parkinsonian syndrome does not smile after whistling. For many years I have employed this simple test as an aid to rapid orientation and have found it to be very helpful and reliable.

2. While I was serving as a house officer at Johns Hopkins Hospital in 1909 a patient was admitted in a suburemic state, showing definite exophthalmos.1 Under treatment she improved and concomitantly the proptosis became less pronounced. After some months she was readmitted and died in uremia. An autopsy confirmed the clinical diagnosis of chronic glomerulonephritis. The thyroid was normal.

Thirty years' experience with the eye signs of Bright's disease, which are similar in every way to those seen in toxic goiter, has proved that they

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