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Russell's sign

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Title: Russell's sign  
Author: World Heritage Encyclopedia
Language: English
Subject: Bulimia nervosa, Medical sign, List of ICD-9 codes 780–799: symptoms, signs, and ill-defined conditions, Gerald Russell, Pastia's lines
Collection: Eating Disorders, Hand, Medical Signs
Publisher: World Heritage Encyclopedia

Russell's sign

Russell's sign, named after British psychiatrist Gerald Russell, is a sign[1] defined as calluses on the knuckles[2] or back of the hand due to repeated self-induced vomiting over long periods of time. The condition generally arises from the afflicted's knuckles making contact with the incisor teeth during the act of inducing the gag reflex at the back of the throat with their finger(s).

This type of scarring is considered one of the physical indicators of a mental illness, and Russell's sign is primarily found in patients with an eating disorder such as bulimia nervosa or anorexia nervosa. However, it is not always a reliable indicator of an eating disorder.

Bulimics who are capable of "handsfree purging", or the induction of vomiting by the willful opening of the esophageal sphincter in a manner similar to belching, while contracting the stomach muscles, do not have Russell's sign.

Martial art practices include push-up exercises during with hands in fists. The support points are the big knuckles of the index and middle finger. Regular exercise result in callouses and hardened skin.


  1. ^ Tyler I, Birmingham CL (November 2001). "The interrater reliability of physical signs in patients with eating disorders". Int J Eat Disord 30 (3): 343–5.  
  2. ^ Strumia R (2005). "Dermatologic signs in patients with eating disorders". Am J Clin Dermatol 6 (3): 165–73.  
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