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August 5, 1968

The Frowning Sign Multiple Forehead Furrows In Peptic Ulcer

Author Affiliations

Washington, DC
West Roxbury, Mass

JAMA. 1968;205(6):470. doi:10.1001/jama.1968.03140320164028

To the Editor:—  Frowning is produced by contraction of the corrugator supercilii muscle. This muscle arises from the lowest point of the frontal bone where it joins the bones of the nose and runs obliquely upwards inserts into the skin under the eyebrows. Its action lowers and brings together the eyebrows so that vertical furrows are formed on the forehead.1One of us (T.A.W.) has had the impression that chronic duodenal ulcer patients have an increased number of vertical furrows on the forehead. William Shakespeare may have made the original observation, as quoth by Othello, Act III, scene 3, "I have a pain upon my forehead here." This study was undertaken to test the validity of such an impression.

Material and Methods:—  Two hundred patients from the gastroenterology and general medicine services at the Walter Reed General Hospital and 200 male veterans are included in this study. One hundred