The Reflex Hammer: A Brief History of the Tool We Know and Love (P2.047)
Citation Manager Formats
Make Comment
See Comments

Abstract
Objective: To examine the origins and evolution of the reflex hammer and its incorporation into neurological clinical practice.
Background: The reflex hammer is an important diagnostic tool used by physicians to test deep tendon reflexes, an essential part of the neurological physical examination in order to assess the peripheral and central nervous system.
Design/Methods: Literature review primarily through PubMed and historical archives.
Results: There are three important milestones leading to the incorporation of the reflex hammer into clinical practice: the discovery of percussion, the description of the clinical usefulness of deep tendon reflexes, and the construction of the first neurological reflex hammer. The reflex hammer found its origins in a wine-growers’ tool used to thump the wine casks in order to measure the amount of wine inside. Based on this practice, Austrian physician Leonard Auenbrugger first described thoracic percussion in 1761. By 1826, percussion had entered clinical practice in mainland Europe and “percussion hammers” were developed and carried by physicians. An important catalyst were the scientific publications by Heinrich Erb and Carl Westphal in 1875 describing the patellar reflex and its implications for diagnosing neurological disease. These papers boosted scientific interest in deep tendon reflexes and the best way to elicit them. In order to assess the reflexes, physicians initially used their hands (“finger taps” or “side hand taps”) and their percussion hammers. However, these were inadequate to reliably elicit the response. It wasn’t until 1888 that the first neurological reflex hammer was developed by John Madison Taylor in Philadelphia, PA. Over the next decades, the reflex hammer continued to evolve and new designs surfaced.
Conclusions: In the face of modern diagnostic and imaging technology, the reflex hammer is a diagnostic tool that continues to evolve and hold its place in history and clinical practice.
Disclosure: Dr. Sisniega has nothing to disclose.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study
Dr. Robert Shapiro and Dr. Amynah Pradhan
Related Articles
- No related articles found.