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1.2.14 Comby Sign
Jules Comby (1853–1947) was born in Pompadour, Corrèz, France, and received
his doctorate from the University of Paris in 1881. He was a physician at the
Trousseau Hospital in 1894 and director of the Hospital for Sick Children, Paris,
from 1894 to 1919 [86–88].
His life work involved the care and study of childhood diseases. He was editor-
in- chief of La Médecine Infantile (Children’s Medicine) in 1894 and co-editor of
Archives de Médecine des Enfants (Archives of Children’s Medicine) from 1898 to
1922. He authored several books, including Traité des Maladies de l’Enfance
(Treatise of the Diseases of Childhood) in 1892, and Les Médicaments chez les
Enfants (Medications for Children) and Formulaire Thérapeutique et Prophylaxie
des Maladies des Enfants (Therapeutic Formulary and Prophylaxis of Children’s
Diseases) in 1900 [89–92].
He described a family of four children who developed a measles rash (Table1.1):
All four had an oral enanthem early in the disease course, which I emphasized a few years
ago with erythema and swelling of the gums and a pultaceous (exudative) coating of the
mucous membrane [93, p.421].
The measles rash was preceded by erythematous tonsillar enlargement, white spots
(exudative pharyngitis), and cervical lymphadenopathy in two of the four children.
Thus, Comby sign refers to an exudate swelling of the gingival and buccal mucosal
and white spots on the tonsils in early measles.
1.2.15 Tresilian Sign
Frederick James Tresilian (1862–1926) was born in London, UK, and received his
medical degree from Queen’s College, Cork, with rst-class honors in 1885, mem-
bership of the Royal College of Physicians (M.R.C.P.) in 1887, a fellowship of the
Medical Society of London in 1897, and fellowship of the Royal College of
Physicians (F.R.C.P.) in 1902 [94–96]. He practiced medicine in Eneld, London,
throughout his career. Initially, he served as a clinical assistant to the ear-nose-
throat, and eye departments at the Prince of Wales’s General Hospital, Tottenham,
and Central London Throat, Nose, and Ear Hospital [94]. At the Eneld War
Hospital, he was appointed Honorary Medical Ofcer. He also served as president
of the North-East Clinical Society and Prudential Assurance Company [94].
Tresilian described an oral nding in children with mumps:
The point I wish to put is, that generally the opening of Stensen duct on the inner surface of
the cheek outside the second upper molar is hard to discover in children; in most of these
cases of mumps it was a bright red papilla, and lasted as such for a week or more. Salivation
likewise occurred in many cases. I could not discover any similar papillary enlargement of
Wharton’s duct, the common opening of the submaxillary and sublingual glands [97,
p.889].
1 Oral Cavity Signs
17
Thus, Tresilian sign refers to erythema and edema involving the papilla of Stensen
duct (Table1.1).
1.2.16 Castellani-Low Sign
Aldo Luigi Mario Castellani (1874–1971) was born in Florence, Italy, and received
his medical degree magna cum laude from the University of Florence in 1899 [98–
101]. He studied under Walter Kruse (1864–1943), most recognized for his work on
Shigella dysenteriae at the Hygiene Institute at the University of Bonn, Germany,
where he discovered in 1902 an agglutination (absorption) reaction that assisted in
differentiating and diagnosing these bacteria [99, 101–104].
Castellani served under the aegis of Sir Patrick Manson (1844–1922) within the
Foreign Ofce at the School of Tropical Medicine, London, beginning in 1901 and
was recommended by Manson to study sleeping sickness epidemic in equatorial
Africa, a commission established by the Royal Society of Physicians [99, 104].
George Michael Low and C.Christie accompanied Castellani during the expedition.
While stationed at Entebbe, Uganda, in 1902, he is believed to be the rst to identify
the parasite trypanosome in the cerebrospinal uid and determine the causal asso-
ciation between this organism and the disease sleeping sickness. This accreditation
was contemptuous because of uncertainty whether he had accomplished this solely
or in consultation and collaboration with Lieutenant-Colonel Sir David Bruce
(1855–1931) [98, 99, 105].
He subsequently served as director of the Bacteriological Institute, professor of
tropical medicine, and lecturer on dermatology, at the Medical College of Colombo,
Ceylon, Sri Lanka, from 1903 to 1915 [98, 101]. His other appointments during that
time included the director of the Colombo Clinic for Tropical Diseases and physi-
cian to the seamen’s ward at the Colombo General Hospital [98]. During his tenure
at the institute, he identied the causative agent of Framboesia or yaws (Treponema
pallidum subsp. pertenue) and its treatment with salvarsan; and the species Bacillus
ceylonensis, later named Shigella sonnei, an organism responsible for the disease
bacillary dysentery [99, 104, 106]. In collaboration with Albert J.Chalmers, he and
Castellani published the Manual of Tropical Medicine with the rst edition in print
in 1910 [101, 107]. Additionally, he discovered many dermatophyte (e.g.,
Trichophyton rubrum) and yeast (Torulopsis estoeilensis) species [108]. He was
instrumental in developing the polyvalent typhoid-paratyphoid vaccine (TAB) and
typhoid-paratyphoid cholera vaccine (TABC), and a solution (carbol fuschin) used
in the treatment of mycotic infections (Castellani paint) [106]. Overall, the depth of
his expertise was broad, spanning the elds of bacteriology, mycology, and parasi-
tology [109].
He served during and after World War I as an Italian medical ofcer in the
Balkans. Castellani was appointed junior Italian representative at the International
Ofce of Public Hygiene in London and Paris and interallied Sanitary Commission
in Poland after the war [99, 104]. He established with Sir William Simpson
1.2 Eponymously Named Signs oftheOral Cavity
18
(1855–1931) the Ross Institute of Tropical Medicine in London, named in honor of
Sir Ronald Ross (1857–1932), Noble Prize laureate for his discovery of malaria
transmission, in 1923. He was appointed Director of Tropical Medicine and
Dermatology and later Director of Mycology and Mycotic Disease when the Ross
Institute became part of the London School of Hygiene and Tropical Medicine in
1934 [98, 99, 101, 104, 110]. He was the editor of the Journal of Tropical Medicine
and Hygiene [99, 100]. Castellani described and named the benign cutaneous condi-
tion dermatosis papulosa nigra while in Jamaica and Central America in 1925. He
served as chair and was responsible for developing the School of Tropical Medicine
at Tulane University in New Orleans, Louisiana, in 1926, later resigning from this
position and was appointed Professor at Louisiana State University [98, 101]. He
also served as chair of the Institute of Tropical Medicine at the University of Rome,
Italy, in 1930 [98, 101, 104, 111].
He served as surgeon general to the Italian army during the Ethiopian War from
1935 to 1936 and as a professor at the Tropical Disease Institute, Lisbon, Portugal,
in 1947 [101, 104]. He cofounded, along with Frederick Reiss, the International
Society of Tropical Dermatology in 1959 (currently the International Society of
Dermatology since 1999) and served as its rst president from 1960 to 1964 [101,
112]. Professor Kasuke Ito established the Castellani-Riess Medal and Award in
their honor, which is:
[t]he highest honor given by the Society in memory of its founders, Aldo Castellani and
Frederick Reiss. It is awarded every ve years at the time of the International Congresses to
that individual who has demonstrated exceptional services to the advancement of the study
of international dermatology and services to humanity as envisioned by our founders
[112, p.23].
He was also the recipient of the Serbian White Eagle, Legion of Honor from France,
Ordronzenia Order by Poland, Italian Military Cross, Knight Order of St. Michael
and St. George (KCMG) by King George V by the British in 1927, and Italian Count
of Kisimaio by King Vittorio Emanuele III in 1935 [98–101, 104].
As a description of his character by Kaue Ito, emeritus professor at Gifu
University School of Medicine in Gifu City, Japan:
His “investigating mania,” as he called it, had led him to explore the then unknown world
of bacteria and pathogenic fungi in the tropics. It was still with him a few months before he
died. However, he was not isolated or imprisoned in a laboratory of academic thought, he
loved the company of human beings. He could “mix with kings without losing the common
touch.” We nd him mixing easily with royalty, but at the same time mourning the death of
his former illiterate servant in Africa, and enjoying his encounters with his patients in
remote parts of Ceylon [104, p.1026].
George Carmichael Low (1872–1952) was born in Monieth, Forfarshire, Scotland.
He received his medical degree with rst-class honors from Edinburgh University in
1897 and a medical degree with a gold medal in 1910 [113–116]. He worked with
Patrick Manson, head of the London School of Tropical Medicine housed within the
Royal Albert Dock (Seamen’s) Hospital, Greenwich, which led to the discovery that
larval Filaria bancrofti is transmitted through the proboscis of Culex fatigans (Culex
1 Oral Cavity Signs
19
quinquefasciatus) mosquito, later conrming it to be the etiology of lymphatic la-
riasis [113, 117]. He was instrumental in establishing the relationship between
Filaria bancrofti to the disease elephantiasis (lymphatic lariasis) and Plasmodium
vivax-infected mosquitoes to human malaria [113, 114]. He accompanied Aldo
Castellani and Cuthbert Christy (1863–1932) in 1902 during an expedition to
Entebbe, Uganda, which led to the discovery of the cause of sleeping sickness [116].
He was appointed superintendent at the London School of Tropical Medicine
from 1903 to 1905, an assistant physician at the Albert Dock Seaman Hospital in
1912, a pathologist at the West London Hospital from 1906 to 1909, consulting
pathologist and lecturer at the London School of Tropical Medicine from 1910 to
1912, and assistant director of Tropical Diseases Bureau in 1912 [113–116, 118].
During World War I, he was a major in the India Medical Services (I.M.S.) at the
Albert Dock Hospital. After the war, he was a full physician in 1918 and a senior
physician in 1919 at the Hospital for Tropical Diseases and Seamen’s Hospital [114,
116, 118, 119].
The London School of Tropical Medicine relocated to Endsleigh Gardens,
Bloomsbury district of central London, in 1920 to become the Hospital for Tropical
Disease, where Low was appointed senior physician until 1937 [114, 115, 118]. The
London School of Tropical Medicine merged with the London School of Hygiene
and renamed the London School of Hygiene and Tropical Medicine, where Low
served as Director of the Division of Clinical Tropical Medicine from 1929 to 1937
[113, 114, 118].
Along with Sir James Cantlie (1851–1926), he was a cofounder of the Society of
Tropical Medicine and Hygiene, established in 1907, later renamed with the sufx
the Royal Society of Tropical Medicine and Hygiene [113, 116]. He also served for
two terms, beginning as the 12th President of the Royal Society of Tropical Medicine
and Hygiene from 1929 to 1933 [114, 118]. He is the recipient of numerous awards,
including the Edinburgh University Straits Settlements Gold Medal in Tropical
Medicine in 1912 and the Mary Kingsley Medal from the Liverpool School of
Tropical Medicine in 1929 [114, 116]. He was appointed an honorary member of
the French Society of Tropical Medicine and a corresponding member of the Society
of Exotic Pathology, Paris [113].
As a description of his character by Sir Neil Fairley:
He was a man of great intellectual honesty, said what he thought and adopted a justiably
critical and somewhat conservative attitude to things medical which were “not proven.” He
was a strict disciplinarian with patients and post-graduate students alike, sound in judg-
ment, and full of that most valuable asset—common sense. Socially, he was a charming and
delightful colleague, and those of us who were privileged to enjoy his friendship know what
kindness, dry humour and sterling lay behind the rugged exterior he sometime presented
[114, p.573].
Castellani and Low divided sleeping sickness into three clinical stages. During the
second stage:
Abnormal muscular movements are perhaps the most striking features of the disease; ne
tremor in the tongue is very constant, and a somewhat coarser tremor is also usual in the
1.2 Eponymously Named Signs oftheOral Cavity
20
hands and arms, any purposeful movements, as lifting a cup to the lips, often increasing it
[120, p.29].
Thus, Castellani-Low sign refers to the ne tremor of the tongue occurring in
patients during the second stage of sleeping sickness (Table1.1).
1.2.17 Schultze Sign
Friedrich Schultze (1848–1934) was born in Ranthenow, Brandenburg, Germany,
completed his medical studies in Berlin and Bonn, and received his medical degree
from the University of Heidelberg in 1871 [121]. That same year, he was appointed
assistant to Nikolaus Friedreich (1825–1882) at the Heidelberg Internal Medicine
Clinic [122]. Schultze habilitated in internal medicine in Heidelberg in 1876, was
appointed associate professor in 1880, and was a professor and director of the medi-
cal clinics at Dorpat University in 1887 and the University of Bonn in 1888 [122].
He cofounded the journal Deutsche Zeitschrift für Nervenheilkunde (German
Journal of Neurology) and along with Hermann Oppenheim (1858–1919), Wilhelm
Heinrich Erb (1840–1921), and Adolph Strümpell (1853–1925) the Society of
German Neurologists [122].
Schultze developed expertise in pediatric neurology, promoting the correlation
of the clinical, anatomical, physiologic, and pathological aspects of neurologic dis-
orders [121, 122]. He described a nding occurring in patients with tetany:
The mechanical excitability of the muscles shows the typical changes precisely, especially
when tapping the muscles of the thenar, gastrocnemius, deltoid, and extensor of the fore-
arms. The muscle contraction was prolonged, with or without concavity formations. The
most exquisite indentation occurred when tapping the half-protruding tongue, with the
musculature taking an unusual form [123, p.4].
Thus, Schultze sign refers to the presence of a concave depression formed by tap-
ping on the tongue in patients with latent tetany (Tab le1.1).
1.2.18 Miécamp (Mirchamp) Sign
We could only identify limited historical information on Etienne-Louis Miécamp
(Mirchamp). He received his medical degree at the University of Montpellier,
France. He published his book Pathogénie de l’Oedème Aigu du Poumon
(Pathogenesis of Acute Pulmonary Edema) in 1900 and Un signe de Diagnostic
Précoce des Oreillons (An early diagnostic sign of mumps) in Le Caducée, a French
journal of military surgery and medicine in 1903 [124, 125]. He was an aide-major
physician of the rst class in 1906, an aide-major physician of the second class in
June 1911, and a recipient of a military prize during his service in North Africa
[126]. Miécamp described a nding found in patients with early mumps parotitis:
1 Oral Cavity Signs
21
Now, the outcomes from his research show that in the early phase of mumps parotitis, as
soon as the swelling occurs, contact on the tongue with a sapid substance causes painful
secretory reex salivation. This painful reex secretion is always more commonly found on
the more swollen side. (…) To obtain this secretion, dilute acetic acid or vinegar is used. In
any case, the patient must be advised to make an effort to swallow, for it is only at that
moment that the painful secretory reex is more commonly produced. Mr. Miécamp thinks
this sign could nearly always detect mumps or conrm the diagnosis in uncertain cases.
Moreover, suppose its nding does not lead to the diagnosis. In that case, we can always
observe the patient with and without this sign and determine which one develops or does
not develop mumps parotitis. There is no doubt that further studies will conrm the clinical
importance of this nding [127, p.313–314].
His name is frequently misspelled as Mirchamp in the English literature. Thus,
Miécamp sign, as an early sign of mumps, refers to the presence of a painful salivary
reex after a sapid substance (dilute acetic acid or vinegar) is placed on the tongue
(Table1.1).
1.2.19 Filatov (Filatoff) Sign
Nil Fedorovich Filatov (Filatoff) (1847–1902) was born in Penza region, Saransk
district of village Mikhailovka, Russia, and received his medical degree from Moscow
State University Faculty of Medicine in 1869. He practiced in the Saransk district,
Prague, Vienna, and Heidelberg [128]. Filatov served as an Associate Professor at
Moscow Soa Children’s Hospital in the Department of Children’s and Women’s
Disease and Obstetrics in 1875, rising to the rank of Professor and Director of the
Department of Children’s Disease at Children’s Hospital at Moscow University in
1891 [128]. He was chair of the Society of Pediatrics of Moscow in 1892 [128, 129].
Filatov is considered the founder of pediatrics in Russia and made signicant
contributions to this specialty [128]. Filatov-Dukes disease, later described by
Clement Dukes (1845–1925) in 1900, was originally called scarlet rubella by
Filatov. He also described idiopathic inammation of the cervical lymph nodes or
Filatov disease, now recognized as infectious mononucleosis. Filatov described in
1895 the dotted grayish-white rash involving the buccal mucosa occurring one day
prior to the measles rash, the same nding reported by Koplick in 1896 [128].
Filatov reported in 1904 the cutaneous ndings in children with scarlet fever:
Some authors erroneously hold that the scarlatinal rash spares the face. In most cases, the
skin of the face is changed peculiarly in scarlet fever so that this disease is promptly recog-
nized directly from the patient’s face, without even undressing him or taking the history.
The peculiarity consists in the pronounced paleness of the lips and of the surrounding skin
in contrast with the bright redness of the cheeks [130, p.646].
Thus, Filatov sign refers to a circumoral pallor of the lips in scarlet fever (Table1.1).
The paper by Filatov titled “Letsii ob Ostrich Infektsionnikh Bolieznyakh u Dietei”
(Lectures of acute infectious diseases in children), published in 1887, has been cited
as containing the rst description of the sign. We were unable to access this
publication.
1.2 Eponymously Named Signs oftheOral Cavity
22
1.2.20 Marfan Sign
Antoine Bernard-Jean Marfan (1858–1942) was born in Castelnaudary, Languedoc-
Roussillon, France, and initially received his medical training at the Faculty of
Medicine in Toulouse, and subsequently in Paris, qualifying in 1887. He was chief
of the clinic at Necker Hospital from 1889 to 1891 [131]. He served as agrégé at the
Sick Children’s Clinic in 1892 and directed the diphtheria ward at the Sick Children’s
Hospital in the Rue de Sèvres in 1901 [132, 133]. Marfan was appointed physician
of the Hospitals of Paris in 1902, professor of therapeutics at the Faculty of
Medicine, Paris, in 1908, chair of infantile hygiene at the Clinic of Early Childhood
Diseases, Paris, in 1914, and chair at the Hospice for Sick-Assisted Children in
1920. There he also established the Institute of Childcare [132, 133].
Marfan is considered the founder of pediatric education in France and undoubt-
edly best recognized for the syndrome which he described in 1896in his paper
titled, “Un cas de déformation congénitale des quatre membres, plus prononcée aux
extrémités, caractérisée par l’allongement des os avec un certain degré
d’amincissement” (A case of congenital deformity of the four limbs, more pro-
nounced at the extremities, characterized by elongation of the bones with some
degree of thinning) [134]. His other areas of interest and publication involved infant
feeding and nutrition, diphtheria, typhoid fever, and disease of infants. He co-edited
with Jules Comby (1853–1947) and Jacques-Joseph Grancher (1843–1907) Traité
des Maladies de l’Enfance (Treatise on Children’s Diseases) in 1897 and with Jean
Martin Charcot (1825–1893), Charles Jacques Bouchard (1837–1915), and Edouard
Brissaud (1852–1909) Traité de Médecine (Treatise on Medicine) second edition in
1901 [135].
Among his other services and accomplishments, he founded the journal Le
Nourrisson (The Infant) in 1913 and served as president of the National Committee
for Childhood [132]. He was selected as a member of the French Academy of
Medicine, section of medical pathology, in 1914, decorated with the Legion of
Honor in 1922, and honorary fellow of the Royal Society of Medicine in 1934
[133]. As a description of his character:
Marfan particularly admired the virtues which were his own: the austerity of private life, the
uprightness of character, the rmness of convictions, the contempt of intrigues, the disdain
of compromises, leading him in all circumstances and whatever may happen to conform his
acts to his mature opinion [132, p.270].
Grancher writes in the second edition of their book Traité des Maladies de l’Enfance
published in 1907:
Before going any further, I would like to express to Mr. Marfan, whose authority in the mat-
ter of pediatrics is so well known and so esteemed, all the regret that his retirement inspires
in us. For entirely personal reasons, Mr. Marfan did not believe he could continue his col-
laboration with us. It is, therefore, under my name and that of M. Comby alone that this
edition will appear [136, p. i-ii].
As described by Mery in the second edition of Traité des Maladies de l’Enfance in
their discussion on typhoid fever:
1 Oral Cavity Signs
23
Mr. Marfan reported a triangle-shaped peeling tongue extending from tip to base. The
tongue has the characteristic red and thin appearance at the edges and at the tip, covered in
the middle with a more or less thick saburral coating. In severe forms, the tongue dries and
covers itself, as well as the lips, with fuliginous [136, p.492].
Thus, Marfan sign is found in patients with typhoid fever. It refers to the red and thin
appearance of the tongue at the tip and edges, along with a yellowish-white plaque
with slightly elongated liform papilla (saburral coating) in the middle—the trian-
gular-shaped denuded region extends from the tip to the base of the tongue
(Table1.1).
1.2.21 Escherich Sign
Theodor Escherich (1857–1911) was born in Ansbach, Bavaria, Germany, studied
medicine at Strasbourg, Würzburg, Kiel, and Berlin, and received his medical
degree in Munich in 1881 [137–140]. He practiced at the medical clinic in Würzburg
as an assistant under the auspices of Carl Adolph Christian Jacob (Karl Adolf
Christian Jakob) Gerhardt (1833–1902) in Juliusspital (Julius Hospital) in the
Department of Internal Medicine from 1882 to 1884, rising to the rank of rst assis-
tant [138–140]. He sought further training in pediatrics in Paris and Vienna at St.
Anna Children’s Hospital in 1884, the latter to which he returned more than a
decade later [138, 141]. At the Vienna Pathological Institute, he conducted bacterio-
logical studies on breast milk [142].
Escherich conducted further bacteriologic studies in Munich beginning in 1884.
He was a clinical assistant in the Children’s Polyclinic of the Reisingerianum and
Hauner Children’s Hospital in Munich under Heinrich von Ranke (1830–1909) in
1885 and Associate Professor in pediatrics at the Ludwig-Maximillian University,
Munich, in 1887 [137, 139, 141, 143]. At the University of Graz, Austria, he was
appointed extraordinary professor and chair of pediatrics of the K.K.Children’s
Clinic in 1890 and ordinary professor in 1894, followed by a professorship of pedi-
atrics and chair at the University of Vienna and St. Anna’s Children’s Hospital,
Vienna, Austria in 1902 [137–141, 144].
He made substantial contributions to infectious diseases in children, including
diphtheria, croup, tetany, and tuberculosis [144]. His name is best recognized in
conjunction with the colonic bacteria Bacterium coli commune, now named
Escherichia coli, rst discovered in 1885 and published in 1886in the text Die
Darmbakterien des Säuglings und ihre Beziehungen zur Physiologie der Verdauung
(The Intestinal Bacteria of the Infant and their Relations to the Physiology of
Digestion) [144, 145]. He served as president of the Austrian Society for Children’s
Research in 1908 and was instrumental in constructing the Imperial Institute of
Maternal and Child Care [142].
As a description of his character:
His energy for work was tremendous, and his disposition strenuous and masterful. He is
described as impulsive, uncommonly strict, strong-willed, faithful, severe with himself but
1.2 Eponymously Named Signs oftheOral Cavity
24
kindly towards others. That the children, his patients, loved him, is evidence that he loved
them and therefore, had a good heart [138, p.474].
He described a nding in patients with tetany termed idiopathic tetany in childhood,
attributed to rickets and hypoparathyroidism:
On the other hand, I am inclined to regard what I have described as mouth phenomena simi-
lar to the true facial reex. It is most easily recognized in healthy, well-developed children
almost regularly during the rst two months of life, especially those who are breastfed. In
some cases, it occurs longer if the mouth or an adjacent area is percussed with a nger or a
hammer during deep sleep. A sharpening and protrusion of the lips occur as if grasping the
nipples, which disappears quickly, sometimes followed by sucking movements. The fact
that the amplitude of the muscle contractions is more clearly perceptible on the non-
percussed side is based on the obvious mechanical conditions. The phenomenon cannot be
triggered in the waking state. In agreement with Thomsen, I consider it probable that this is
a process related to the sucking reex, and conclude from this fact that it is only present in
very young and sleeping children, and in later age only in pathological cases, and that the
same is often successfully triggered only after prolonged regularity percussion attempts.
Hence, this phenomenon is not found exclusively in tetany [146, p.57].
Thus, Escherich sign refers to the protrusion of the lips when tapping the mouth or
adjacent areas (lips or tongue) in patients with tetany or latent tetany secondary to
hypoparathyroidism (Table1.1).
1.2.22 Gaucher Sign
Charles Phillipe Ernest Gaucher (1854–1918) was born in Champlemy, Nièvre,
France, studied medicine at the Faculty of Medicine, Paris, and served as an intern
of the Paris Hospitals in 1877 and histology technician in 1880 [147–149]. He
received his medical degree at the Faculty of Medicine, Paris, in 1882 based on his
thesis De l’épithélioma primitif de la rate (On Primary Epithelioma of the Spleen)
later eponymously recognized as Gaucher disease [147, 149–151], and chief of the
medical clinic at Charité Hospital from 1882 to 1884 [150]. He was appointed phy-
sician to the Paris Hospitals in 1886, physician of the Hospital Saint-Antoine, and
professor agrégé of the Faculty of Medicine in 1892 [148, 150]. He served as clini-
cal professor and chair of Cutaneous and Syphilitic Disease at the Saint-Louis
Hospital in 1902 [147–151]. During World War I, he was appointed chief physician
of the Military Hospital, Villemin [147, 148, 150, 151].
Gaucher founded the journal Annales des Maladies Vénériennes (Annals of
Venereal Diseases) in 1906. He was elected member of the Paris Academy of
Medicine in 1910 and president of the General Association of Doctors of France and
the Medical Society of the Hospitals of Paris [147, 148, 150]. He was anointed
Ofcer of the Legion of Honor in 1917in recognition of his contributions at the
Villemin Hospital during World War I [150, 151].
1 Oral Cavity Signs
25
According to Georges Baudouin:
Under a somewhat rough exterior, which made those who knew him but slightly judge him
unjustly, there were hidden an excellent heart, an upright character, and absolute profes-
sional rectitude. Especially kind and considerate to the unfortunate, he unstintingly gave his
charitable soul and zealously devoted himself to the organization and development of the
Medical War Fund (Caisse Médicale de Guerre) which was established for the assistance of
the unfortunate confrères and of the widows and children of physician who had been cruelly
stricken by the war [148, p.573].
Gaucher reported in a series of 16 patients an unusual partition of the incisors in
patients with congenital syphilis:
To draw from the previous presentation the lesson it contains, I would like you to remember
that in addition to the numerous stigmata of hereditary-syphilis today well known and,
particularly in addition to the classic dental dystrophies, so well described by Hutchinson,
by Fournier and by Parrot, there is one whose special value is not known, the importance of
which I have just demonstrated to you and to which I call the attention of physicians,
namely the separation of the upper middle incisors [152, p.823].
Gaucher noted that the separation of the upper middle incisors might occur as an
isolated nding or along with other stigmata of congenital syphilis.
1.2.23 Hathcock Sign (Hathchock Sign)
Thomas Alexander Hathcock Jr. (1865–1943) was born in Albemarie, North
Carolina, USA, and received his medical education at the Baltimore Medical
College, University of Maryland, Baltimore, graduating in 1894 [153]. He practiced
in Norwood, North Carolina, and served in public ofce as county commissioner,
mayor, school committee, and board of commissioners [154]. During World War I,
he served as First Lieutenant at Medical Ofcers Training Camps in Greenleaf,
Chickamauga Park (Fort Oglethorpe), Georgia, later transferring to the Base
Hospital at Camp Wheeler Macon, Georgia [153, 154].
He described his eponymously named sign at Camp Wheeler during a Mumps
epidemic. He was promoted to captain in 1918 and discharged as major that same
year [153]. After the war, he returned and served as superintendent at Norwood
Methodist Church and president of Stanley Oil, Riverview Milling, Norwood
Electric and Water, Norwood Development, Bank of Norwood, and surgeon to
Southern Norfolk-Southern railroads [153]. As reported by Lieutenant M.J.Radin
in 1918 (Fig.1.1):
The most diagnostic prodromal sign, pathognomonic, in fact, was rst noted by Lieutenant
Hathcock, who has personally observed and treated over 2000 cases, and who is, from the
standpoint of knowledge gained by close clinical observation of the disease, probably the
best authority on mumps in the United States. The sign is tenderness just beyond the angle
of the jaw on running the nger toward the angle, under the mandible. If the parotid gland is
at all involved, the patient winces with pain. This occurs before any swelling can be made
out. It is proper and tting—much as eponyms are held by some to be improper—that this
sign go down in the literature as Hathcock’s sign. It is almost constant, it is early, it is denite
and it is exclusive; therefore, it is diagnostic, like Koplik’s spots in measles [155, p.360].
1.2 Eponymously Named Signs oftheOral Cavity