Harvey's 1 and 2

Abstract

Neurology abounds with eponymous clinical signs and tests – Babinski, Hoffman, Unterberger and Hallpike, to name but a few. Marcus Gunn has two, or is it three? Here are two more. HARVEY’S FIRST SIGN When faced with a patient feigning coma or status epilepticus the traditional ‘stimulus’ is to rub a knuckle on the sternum, or to press a thumb into the supraorbital notch, or to pinch a finger nail bed, and then stand clear. There is now no need for these mediaeval ploys. Harvey’s first sign was discovered serendipitously one hot summer afternoon in a stuffy south-facing out-patient room in the early 1960s in the Middlesex Hospital, Mortimer Street, London. A limp band of desultory students were watching a senior ear, nose and throat consultant prod the back of somebody’s nose with a long, thin, shiny instrument. I, the limpest and most desultory, was sitting at the back of the