WESTPHAL'S SIGN

\wˈɛstfə͡lz sˈa͡ɪn], \wˈɛstfə‍lz sˈa‍ɪn], \w_ˈɛ_s_t_f_əl_z s_ˈaɪ_n]\
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1898 - American pocket medical dictionary
By Willam Alexander Newman Dorland
 
1916 - Appleton's medical dictionary
By Smith Ely Jelliffe