Historische Bemerkungen zum sogenannten Babinskischen Phänomen

Abstract

A study of the neurological literature, particularly that of the 19th century, discloses that Babinski's credit for the phenomenon which carries his name, and on which he first reported on 22nd February 1896, is exaggerated when not only the introduction of this phenomenon to neurological diagnosis but also the priority of its discovery is attributed to him. This has been pointed out as early as 1952 in the second edition of Wartenberg's monograph Die Untersuchung der Reflexe. Prior to Babinski, investigators such as Marshall Hall (1842), R. D. Grainger (1837), A. Strümpell (1881), C. Westphal (1874) and E. Remak (1893) had described this sign, thus exerting a decisive influence on the entire further development. Strümpell (not Babinski, as is usually assumed) was the first to recognize the correlation between the occurrence of this phenomenon and a lesion of the pyramidal tract. Unlike current investigators, Babinski primarily sought the special diagnostic value of the sign in the differentiation between an organic neural disorder and a psychogenic disorder of behaviour. As component of a phylogenetically older programme of innervation, the sign is regarded by Walshe (1947) as a release phenomenon which ensures the individual's horizontal or vertical flight ( e.g. Wartenberg 1952). The phenomenon (component of a so-called mass flexor reflex) has of old been known to physicians as a pathognomonic sign, e.g. of diseases associated with hemiplegia. The so-called Babinski phenomenon can be expected, not only in the presence of a pyramidal tract lesion in the stricter sense, but in all cases in which, independent of certain pathways of transmission, there is within the cerebrospinal functional unit a disturbance of corticofugal information and, therefore, dissociation of the cerebrospinal ( i.e. disinhibition of the spinal) functional circuits.