The Telltale Palm

Palm reading as a form of fortune-telling is as phony as it is ancient. As an aid to medical diagnosis, it is as promising as it is new. The latest addition to the arcane art comes from the strange palm-print patterns found on babies born to mothers who had German measles early in their pregnancy during the epidemic that swept the U.S. in 1964-65. Since these are babies likely to be suffering from hidden but serious abnormalities, reports Brooklyn's Dr. Ruth Achs, the visible but minor abnormalities of their palms may well be a valuable medical clue.

Inborn Defects. The first suggestion that finger and palm prints might be associated with disease came only 30 years ago, almost half a century after Sir Francis Gallon linked them with genetics, and helped to lay the foundations of a science now called dermatoglyphics. Dr. Harold Cummins of Tulane University noted a distinctive pattern in victims of mongolism (Down's syndrome). Another Tulane team, led by Dr. Alfred R. Hale, showed that many patients with inborn heart defects had palm-ridge abnormalities, whereas those with heart disease or disorders acquired after birth usually had normal prints.

By the end of 1965, researchers had linked abnormal palm prints with no fewer than 19 disorders (counting many chromosomal mixups), including two more forms of mongolism, the absence of fingernails or toenails, webbing between the fingers and toes, and possibly phenylketonuria or PKU.

Last week, in the New England Journal of Medicine, Dr. Achs and Dr. Rita Harper ran the number of palm-printed abnormalities up to 20. And although most such disorders involve chromosomal defects determined at the moment of conception, the latest implicated a viral disease. To get clear prints from the hands of tiny, squirming infants, Dr. Achs and her colleagues found that the policeman's inkpad and fingerprint technique would not do; instead they used a direct photographic method developed by New York's Philips Laboratories. The babies' palms were pressed against a prism so that the print was reflected and magnified, and could be photographed with a Polaroid camera.

Simian Line. What Dr. Achs and other medical "palmists" look for is half a dozen common abnormalities. A single deep crease, instead of two separated lines, from the base of the index finger to the base of the pinkie is known as a "simian line" (see diagram). It occurs with many disorders including mongolism and some rubella (German measles) defects. Also unusual is a radial loop pattern pointing toward the thumb in the ridges of any finger other than the index.

Then there are five places where the normal palm shows what researchers call a triradius--a wide-open letter Y formed by the junction of three lines. The crucial one is the axial triradius; on most palms it is just above the first flesh crease where hand joins wrist. If, in both hands, it is higher up, closer to the fingers, it may indicate inborn abnormalities from rubella or other causes.

British researchers measure the angle between the axial triradius and those at the base of the index and little fingers. The normal angle is around 48DEG; the higher the axial triradius, the larger the angle--around 80DEG in mongolism, and still greater in some of the other chromosomal abnormalities.

Palm prints are fully determined in the first four months of life in the womb, when the fetus is most liable to damage from viral or other harmful agents. (Researchers will now check unusual palm prints as clues to possible causes of mental retardation other than rubella.) Alone, the prints do not establish a diagnosis, Dr. Achs emphasizes. But they should prompt the physician to make a more thorough examination than usual, to find out whether there are indeed hidden abnormalities. Rubella, for example, often causes defects in the heart and impairment of hearing that otherwise might not be suspected for months or even years. And prompt detection can lead to more effective treatment.

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