Neisser and the flow of seed

Neisseria gonorrhoeae, a gram-negative intracellular diplococci, was identified in 1879 by the German physician, Albert Neisser, and is the causative agent of gonorrhea, one of the oldest recognized sexually transmitted diseases.

The term "gonorrhea" is derived from the Greek language and literally means "flow of seed"; this term was used to describe the white milky appearance of the purulent urethral discharge, which was mistaken for semen.


Neisser was also the co-discoverer of the causative agent of leprosy. In 1879 the Norwegian physician Gerhard Armauer Hansen gave to young Neisser (who had visited him in Norway to examine some 100 leprosy patients) some tissue samples of his patients. Neisser successfully stained the bacteria and announced his findings in 1880, claiming to have discovered the pathogenesis of leprosy. There was some conflict between Neisser and Hansen, because Hansen had failed to culture the organism and demonstrate unequivocally its link to leprosy, although he had observed the bacterium since 1872.

Discovery of Vitamin B12

B12 deficiency is the cause of pernicious anemia, an anemic disease that was usually fatal and has unknown etiology when it was first described in medicine. The cure, and B12, were discovered by accident. George Whipple had been doing experiments in which he induced anemia in dogs by bleeding them, and then fed them various foods to observe which diets allowed them fastest recovery from the anemia produced. In the process, he discovered that ingesting large amounts of liver seemed to most-rapidly cure the anemia of blood loss. Thus, he hypothesized that liver ingestion might treat pernicious anemia. He tried this and reported some signs of success in 1920.

After a series of careful clinical studies, George Richards Minot and William Murphy set out to partly isolate the substance in liver which cured anemia in dogs, and found that it was iron. They also found that an entirely different liver substance cured pernicious anemia in humans, that had no effect on dogs under the conditions used. The specific factor treatment for pernicious anemia, found in liver juice, had been found by this coincidence. Minot and Murphy reported these experiments in 1926. This was the first real progress with this disease. Despite this discovery, for several years patients were still required to eat large amounts of raw liver or to drink considerable amounts of liver juice.

In 1928, the chemist Edwin Cohn prepared a liver extract that was 50 to 100 times more potent than the natural liver products. The extract was the first workable treatment for the disease. For their initial work in pointing the way to a working treatment, Whipple, Minot, and Murphy shared the 1934 Nobel Prize in Physiology or Medicine.

These events in turn eventually let to discovery of the soluble vitamin, called vitamin B12, in the liver juice. The vitamin in liver extracts was not isolated until 1948 by the chemists Karl A. Folkers of the United States and Alexander R. Todd of Great Britain. The substance proved to be cobalamin—the most complex of all the vitamins. It could also be injected directly into muscle, making it possible to treat pernicious anemia more easily

Dorothy Hodgkin completed the elucidation of B12's chemical structure by using x-ray crystallography, receiving the 1964 Nobel Prize in chemistry for her work. Vitamin B12 was finally synthesized by Robert Burns Woodward in 1971, after a ten year effort.

James W. Black

Sir James Whyte Black, OM, FRS, FRSE, FRCP (14 June 1924 – 22 March 2010) was a Scottish doctor and pharmacologist. He spent his career both as researcher and as an academic at several universities. Black established the physiology department at the University of Glasgow, where he became interested in the effects of adrenaline on the human heart. He went to work for ICI Pharmaceuticals in 1958 and, while there, developed propranolol, a beta blocker used for the treatment of heart disease. Black was also responsible for the development of cimetidine, a drug used in a similar manner to treat stomach ulcers. He was awarded the Nobel Prize for Medicine in 1988 for work leading to the development of propranolol and cimetidine

St Barbara and Barbiturates

Barbituric acid was first synthesized on December 6, 1864, by German researcher Adolf von Baeyer. This was done by condensing urea (an animal waste product) with diethyl malonate (an ester derived from the acid of apples). There are several stories about how the substance got its name. The most likely story is that Von Baeyer and his colleagues went to celebrate their discovery in a tavern where the town's artillery garrison were also celebrating the feast of Saint Barbara — the patron saint of artillerists. An artillery officer is said to have christened the new substance by amalgamating Barbara with urea.[1] No substance of medical value was discovered, however, until 1903 when two German chemists working at Bayer, Emil Fischer and Joseph von Mering, discovered that barbital was very effective in putting dogs to sleep. Barbital was then marketed by Bayer under the trade name Veronal. It is said that Von Mering proposed this name because the most peaceful place he knew was the Italian city of Verona.[1] It was not until the 1950s that the behavioural disturbances and physical dependence potential of barbiturates became recognised

Selman Waksman and Streptomycin

Selman Abraham Waksman (22 July 1888 – 16 August 1973) was an American biochemist and microbiologist whose research into organic substances—largely into organisms that live in soil—and their decomposition promoted the discovery of Streptomycin, and several other antibiotics. A professor of biochemistry and microbiology at Rutgers University for four decades, his work led to the discovery of over twenty antibiotics (a word which he coined) and procedures that have led to the development of many others. The proceeds earned from the licensing of his patents funded a foundation for microbiological research, which established the Waksman Institute of Microbiology located on Rutgers University's Busch Campus in Piscataway, New Jersey (USA). In 1952 he was awarded the Nobel Prize in Physiology or Medicine in recognition "for his discovery of "streptomycin" the first antibiotic active against tuberculosis", despite the fact that this medicine was indeed discovered by Albert Schatz, one of Waksman's graduate investigators working under his direction.

In 2005 Selman Waksman was designated an ACS National Historical Chemical Landmark in recognition of his significance for isolating more than fifteen antibiotics, including streptomycin, which was the first effective treatment for tuberculosis

Razi

Muhammad ibn Zakariyā Rāzī (Mohammad-e Zakariā-ye Rāzi: Persian: محمد زکریای رازی), known as Rhazes or Rasis after medieval Latinists, (August 26, 865, Rayy— 925, Rayy) was a Persian  physician, alchemist and chemist, philosopher, and scholar. He is recognised as a polymathm and Biographies of Razi, based on his writings, describe him as “perhaps the greatest clinician of all times.” Numerous “firsts” in medical research, clinical care, and chemistry are attributed to him, including being the first to differentiate smallpox from measles, and the discovery of numerous compounds and chemicals including alcohol and kerosene, among others. Edward Granville Browne considers him as "probably the greatest and most original of all the physicians, and one of the most prolific as an author".

Although Rhazes (or Razi) was a Persian living in Iran, his work was published in both Persian and Arabic lanugages, as such was the case for most Persian scientists during this era. Such multi-lingual publications in Persia were analogous to the later usage of the Latin language for scientific publications in Europe in the following centuries.

Rhazes made fundamental and enduring contributions to the fields of medicine, alchemy, music, and philosophy, recorded in over 200 books and articles in various fields of science. He was well-versed in Persian, Greek and Indian medical knowledge and made numerous advances in medicine through own observations and discoveries.

Well educated in music, mathematics, philosophy, and metaphysics, he finally chose medicine as his professional field. As a physician, he was an early proponent of experimental medicine and is considered the father of pediatrics. He was also a pioneer of neurosurgery and ophthalmology. He was among the first to use Humoralism to distinguish one contagious disease from another. In particular, Razi was the first physician to distinguish smallpox and measles through his clinical characterization of the two diseases. And as an alchemist, Rhazes is known for his study of sulfuric acid and for his discovery of ethanol and its refinement to use in medicine. He became chief physician of Rayy and Baghdad hospitals. Razi Invented what today is known as rubbing alcohol.

Rhazes was a rationalist and very confident in the power of ratiocination; he was widely regarded by his contemporaries and biographers as liberal and free from any kind of prejudice and very bold and daring in expressing his ideas without a qualm.

He traveled extensively but mostly in Persia. As a teacher in medicine, he attracted students of all disciplines and was said to be compassionate and devoted to the service of his patients, whether rich or poor.

The Discovery of Insulin

The story of the discovery of insulin has been well chronicled beginning with a young physician, Frederick Banting, in London, Ontario, imagining that it might be possible to isolate the internal secretions of the pancreas by ligating the pancreatic ducts to induce atrophy of the acinar cells and thereby minimize contamination of the tissue extract with digestive enzymes. Banting presented his suggestion to J. J. R. Macleod, a distinguished physiologist at the University of Toronto who provided Banting with a laboratory for the summer and some dogs for the experiments. Macleod was initially skeptical, but eventually agreed to let Banting use his lab space while he was on vacation for the summer. He also supplied Banting with ten dogs to experiment on, and two medical students, Best and Clark Noble, to use as lab assistants, before leaving for Scotland. Since Banting only required one lab assistant, Best and Noble flipped a coin to see which would assist Banting for the first half of the summer. Best won the coin toss, and took the first shift as Banting's assistant. Loss of the coin toss may have proved unfortunate for Noble, given that Banting decided to keep Best for the entire summer (and eventually shared half his Nobel Prize money and a large part of the credit for the discovery of insulin with the winner of the toss)

During the summer of 1921, Banting and Best made remarkable progress, and by fall they had isolated material from pancreas extracts that dramatically prolonged the lives of dogs made diabetic by removal of the pancreas. In the winter of 1922, Banting and Best treated their first human patient, a young boy, who's life was saved by the treatment. This was a stunning accomplishment. Consider that from the start of the research in the summer of 1921 to treating a human patient successfully in the winter of 1922, the pace, especially by current standards for clinical treatments, was remarkable.

With that achievement, Macleod, who had been initially unenthusiastic about the work, assigned his entire laboratory to the insulin project. He also enlisted the Eli Lilly Company to aid in the large scale, commercial preparation of insulin although the University of Toronto received the patent for insulin production. By 1923, insulin was available in quantities adequate for relatively widespread treatment of diabetes. Although the success of the insulin project was remarkable, the rewards for the research workers were, it seems, quite controversial. The 1923 Noble Prize in Physiology or Medicine was awarded to Banting and Macleod. Apparently, Banting was annoyed at the omission of Best and gave him half of his share of the prize. There was also, perhaps, the feeling that Macleod had done little in the initial stages of the work and was an undeserving recipient. Macleod split his share of the Prize with J. B. Collip who had made contributions to the later stages of the work on insulin purification.

After the spectacular events of 1921–1923, the University of Toronto established the Banting and Best Department of Medical Research separate from the University. Banting accomplished little during the rest of his career and died in a plane crash in 1940. Best, however, had a long successful tenure at the University of Toronto working on insulin and subsequently other important topics including the importance of dietary choline and the development of heparin as an anticoagulant.

Read more at The Discovery of Insulin: the Work of Frederick Banting and Charles Best Robert D. Simoni, Robert L. Hill and Martha Vaughan /The Journal of Biological Chemistry,

Auenbrugger and the wine barrels

Josef Leopold Auenbrugger or Leopold von Auenbrugg (b. November 19, 1722, Graz, Austria; died May 17, 1809), Austrian physician who invented percussion as a diagnostic technique. On the strength of this discovery, he is considered one of the founders of modern medicine.[citation needed]

Auenbrugger was a native of Graz in Styria, an Austrian province. His father, a hotel keeper, gave his son every opportunity for an excellent preliminary education in his native town and then sent him to Vienna to complete his studies at the university. Auenbrugger was graduated as a physician at the age of 22 and then entered the Spanish Military Hospital of Vienna, where he spent 10 years.

He found out that, by tapping lightly on the chest, one could assess the texture of underlying tissues and organs. This technique had its origins in testing the level of wine casks in the cellar of his father's hotel. With this method, he was able to plot outlines of the heart. It was the first time that a physician could relatively accurately and objectively determine an important sign of diseases. He published his findings in a booklet, but nobody paid much attention to it. The value of percussion in physical examination was later recognized by Jean-Nicolas Corvisart, who popularized it teaching it to his students in France, and by Josef Skoda in Vienna.

During his ten years of patient study, Auenbrugger confirmed his observations on the diagnostic value of percussion by comparison with post-mortem specimens, and besides made a number of experimental researches on dead bodies. He injected fluid into the pleural cavity, and showed that it was perfectly possible by percussion to tell exactly the limits of the fluid present, and thus to decide when and where efforts should be made for its removal.

His name is also associated with Auenbrugger's sign, a bulging of the epigastric region in the thorax, in cases of large effusions of the pericardium, the membrane which envelops the heart.

His later studies were devoted to tuberculosis. He pointed out how to detect cavities of the lungs, and how their location and size might be determined by percussion. He also recognized that information with regard to the contents of cavities in the lungs and conditions of lung tissue might be obtained by placing the hand on the chest and noting the vibration, or fremitus, produced by the voice and breath. These observations were published in a little book called Inventum Novum, the full English title being, "A New Discovery that Enables the Physician from the Percussion of the Human Thorax to Detect the Diseases Hidden Within the Chest". It is now considered one of the most important classics of medicine.

Like most medical discoveries, Auenbrugger's method of diagnosis at first met with indifference. Before his death, however, it had aroused the attention of French physician René Laennec, who, following up the ideas suggested by it, discovered auscultation.

Auenbrugger lived to a happy old age. He was especially noted for his cordial relations with the younger members of his profession and for his kindness to the poor and to these suffering from tuberculosis. He is sometimes said to have died in the typhus epidemic of 1798, but the burial register of the parish church in Vienna, of which he had been for half a century a faithful member, shows that he did not die until 1807.

Rene Laennec and the Stethoscope

When Rene Laennec was 5 years of age, his mother died of tuberculosis, and he was sent to live with an uncle who was a priest. At the end of the French revolution, 4 years later, Laennec was sent to live with another uncle, Dr Guillaume Laennec of Nantes, and remained with him until he was 19 years of age. Dr Laennec's was a pious Catholic household with a humanistic cultural environment that, of course, included an interest in medicine.

In 1800, Laennec left for Paris to seek medical education with Corvisart at La Charite Hospital. There he manifested an avidity for anatomy, pathology, clinical medicine, research, and writing papers. He received a degree in 1804, and continued with his mentor.


Laennec accepted an offer in 1816 from Necker Hospital to serve as physician. It was there that he invented the stethoscope. Laennec diligently followed patients with chest ailments from the bedside to the autopsy table, and correlated sounds heard with organ pathology found. He soon reached the conclusion that intrathoracic organs generated specific sounds with speaking, breathing, and coughing in health and in disease; and that these sounds could be conveyed to the ear with a stethoscope. Laennec developed an instinctive skill in the diagnosis of intrathoracic organ disease from sounds heard with the new instrument.

In 1819, Laennec published the results of his research, Traite de l'auscultation mediate et des maladies des poumons et des coeur. The following passage related how the stethoscope was invented and its usefulness: "In 1816, I was consulted by a young woman with symptoms of a diseased heart...percussion was of little avail on account ...of fatness. The application of the ear... inadmissible by the age and sex of the patient. I recollected a fact in acoustics ... the augmented sound conveyed through solid bodies....I rolled a quire of paper into a cylinder and applied one end to the heart and one end to the ear...and thereby perceived the action of the heart...more clear and distinct. I have been enabled to discover new signs of the diseases of the lungs, heart and pleura."

During all his life of 45 years, Laennec was thin and sickly looking, but this did not limit his practice, teaching, research, hospital responsibilities, and writing. Arduous work, however, finally took its toll on his health: "I know that I have risked my life, but the book I'm going to publish will be, I hope, useful enough to be of more value than the life of a man."

Laennec left for Brittany, his birthplace, recovered his health, and returned to Paris in 1822. He succeeded his deceased mentor at the College de France, was appointed professor of medicine at both Necker and La Charite, and was made a Knight of the Legion of Honor. Foreign students flocked to Paris to learn the new medicine and the use of precussion and the stethoscope. Some were Americans who returned home inspired to transform a stagnant medicine.

The second edition of Traite (1826) introduced a nomenclature of auscultatory sounds (rales, fremitus, egophony, pectoriloquy, bronchophony) heard in organ pathology that formerly was called "lung fever." Again arduous work severely taxed Laennec's health and strength. He returned to Brittany and died on August 13, 1826.

It was not until 1821 that The New England Journal of Medicine reported the invention of the stethoscope. In 1885, a professor of medicine in the United States stated, "He that hath ears to hear, let him use his ears and not a stethoscope"; and the founder of the American Heart Association, L. A. Connor (1866-1950) carried a silk handkerchief to place on the wall of the chest for ear auscultation. Nevertheless, this useful substitute for the ear quickly began winning converts.

The word stethoscope comes from the Greek words stethos meaning "chest", and skopos meaning "observer."

Read the original article, The inventor of the stethoscope: Rene Laennec - Journal of Family Practice, August, 1993 by Harry Bloch http://findarticles.com/p/articles/mi_m0689/is_n2_v37/ai_13248765/

Moniz and Lobotomy

António Caetano de Abreu Freire Egas Moniz (November 29, 1874 – December 13, 1955), known as Egas Moniz, was a Portuguese neurologist and the developer of cerebral angiography, best known for introducing the controversial psychosurgical procedure leucotomy (also known as lobotomy), for which be became the first Portuguese national to receive a Nobel Prize.

He wrote broadly on topics within and outside[citation needed] medicine, and also held several legislative and diplomatic posts in the Portuguese government.

Rosemary Kennedy, sister to John, Robert, and Edward Kennedy underwent a lobotomy at age 23, which left her permanently incapacitated. Her sister, Eunice Kennedy Shriver, founded the Special Olympics in her honor in 1968.

HeLa cells

The living cells of a woman who died of cervical cancer more than half a century ago could reveal how we might extend our own lifespans.

Secrets of immortality could be tantalisingly close. The woman in question is Henrietta Lacks, whose tragedy has allowed researchers around the world to better understand the links between cancer, when cells seem to be able to multiply indefinitely, and ageing, when they become senescent and lose the ability to divide.

The story of this research dates back to the winter of 1951 when the mother of five underwent a seemingly routine biopsy for a suspicious cervical mass. A portion went to the pathology lab for diagnosis but, unknown to the black 31-year-old, another was diverted for research by two investigators at Johns Hopkins University, Baltimore.

In a review in the journal Nature, Dr Toren Finkel of the National Heart Lung and Blood Institute, Bethesda, and Manuel Serrano and Maria Blasco in the Spanish National Cancer Research Centre, Madrid, conclude: "The small part that remained in the laboratory would forever change the course of science."

George Otto Gey and Martha Gey of Johns Hopkins had spent the better part of the preceding two decades attempting to find a human cell that could grow indefinitely in the lab. That search would end with the arrival of the biopsy sample taken from Lacks.

Although Lacks died eight months later, her fast-growing cells still multiply in vials of red liquid held by laboratories around the world. Known as 'HeLa' cells in her honour, there are probably more alive today than in her entire body when she lived and have conferred on her a kind of immortality. To researchers studying human ageing, they pose a fundamental question: If human tissue cells can live indefinitely, why not people?

Her cells help lead to a clearer understanding of the barriers that separate normal cells from their cancer counterparts, says Dr Finkel. "These same barriers now appear to be intimately connected to how and why we age. Perhaps Henrietta's final gift to us is the growing realisation that somewhere within the curse of the cancer cell's immortality there might also lie the secret of how we might understand and extend our own lifespan."

Researchers have been slowly stripping away the many secrets that endow cancer cells with the gift of immortality. One of the most promising lines of research is into telomeres, protective caps that form around chromosomes - bundles of genes - in cells. Every time the cell divides, the telomeres get a little shorter until the cell self-destructs. But cancer cells can rebuild them with an enzyme called telomerase.

On the day Lacks died, George Gey himself appeared on American TV to announce the dawn of a new era in medical research. For the first time, he explained, it was possible to grow human cells continuously in culture. Since then, her cells have become a standard laboratory tool for studying the effects of radiation, growing viruses and testing medications.

Initially, the cell line was said to be named after a "Helen Lane" or "Helen Larson", in order to preserve Lacks's anonymity.

They helped eradicate polio, flew in early space shuttle missions and sat in nuclear test sites around the world. They have been subject to genetic analysis, revealing the presence of a human papillomavirus now thought to cause the disease and that they probably have the same mutations as present half a century ago, helping to answer many scientific questions.

"Undoubtedly, none of these questions were contemplated on that day in October 1951 when Henrietta Lacks's body was laid to rest in an unmarked grave near her family's small tobacco farm," they write in Nature "Unbeknownst to those who gathered in that Virginia field-but as we now know-not all of Henrietta was buried that day."

The family was not asked for consent, a sad commentary on biomedical research in the 1950s, when it was not uncommon for doctors to conduct research on patients without their knowledge. Because Gey had called them HeLa cells, it was only years later that the family only discovered her strange legacy to modern science

Read more at http://www.telegraph.co.uk/science/science-news/3303912/How-Henriettas-cells-gave-us-new-hope.html

Another interesting read http://www.nytimes.com/2010/02/02/health/02seco.html?em A Lasting Gift to Medicine That Wasn’t Really a Gift by Denise Grady/ NY Times

St Anthony's Fire - Ergotism

Not in years had France seen such rain. Farmers slogged stolidly out to their fields to harvest the sodden crops, mill the grain and send it on its way. In little (pop. 4,400) Pont-Saint-Esprit, perched on a bluff along the River Rhone in southern France, the townspeople sat glumly in their bistros sipping wine, watching the swollen river slip past the medieval bridge which gives the town its name.

Then, without warning, pain and sudden death clutched Pont-Saint-Esprit. On a Saturday night three weeks ago, the town's doctors began getting calls from people complaining of heartburn, stomach cramps and fever chills. At first, they thought it was a mild epidemic of meat poisoning. But the calls kept flooding in. By Monday, 70 houses in the village had become tiny hospitals, with most of their families in bed. Then the doctors found their first clue: every one of the patients had eaten bread from the shop of Baker Roch Briand. All eight of Pont-Saint-Esprit's bakeries were ordered temporarily shut.

Red Flowers & Molten Lead. That night the first man died in convulsions. Later, two men who had seemed to be recovering dashed through the narrow streets shouting that enemies were after them. A small boy tried to throttle his mother. Gendarmes went from house to house, collecting pieces of the deadly bread to be sent to Marseille for analysis. Among the stricken, delirium rose: patients thrashed wildly on their beds, screaming that red flowers were blossoming from their bodies, that their heads had turned to molten lead. Pont-Saint-Esprit's hospital reported four attempts at suicide.

What was the mysterious madness? Pont-Saint-Esprit speculated that the village idiot had hexed Baker Briand's flour, that the flour had been packed in fertilizer sacks, that rats in the grain elevator had contaminated the flour. The police knew better. They had traced the flour back from Briand's bakeshop through the government-controlled flour depot to a mill near Poitiers, nearly 300 miles away.

The Parasite. Last week the word came back from the police laboratory:"We have identified a vegetable alkaloid having the toxic and biological characteristics of ergot, a cereal parasite." Pont-Saint-Esprit had been stricken by ergot poisoning, a medieval disease as old as its proud bridge, so old that it had almost been forgotten. Modern medicine knows about ergot, but has rarely seen it in the form of an epidemic disease.* It is a black fungus that grows on wet grain, contains chemicals that powerfully affect the blood vessels and the nervous system. Doctors often use ergot extracts to start contractions in the uterus in childbirth.

In the Middle Ages, growing uncontrolled in wet summers, ergot was no such helpful friend. The disease was called "St. Anthony's Fire," and raged periodically through Europe. Monastic chroniclers wrote of agonizing burning sensations, of feet and hands blackened like charcoal, of vomiting, convulsions and death. Whole villages were driven mad. That, in effect, was what had happened to Pont-Saint-Esprit in 1951.

By week's end, French police had found the miller who ground the ergot-laden rye and a man who acknowledged selling him the grain, charged them both with involuntary homicide. In Pont-Saint-Esprit, the toll of illness passed 200; four had died, 28 were still on the critical list. France considered itself lucky: all the contaminated grain seemed to have gone into that one bag of flour delivered to Baker Roch Briand


Read more: http://www.time.com/time/magazine/article/0,9171,815355-2,00.html#ixzz0bhDFMQL7

Anthony the Great (c 251–356), (different from St Antony of Padua) also known as Saint Anthony, Anthony the Abbot, Anthony of Egypt, Anthony of the Desert, Anthony the Anchorite, Abba Antonius (Ἀβᾶς Ἀντώνιος), and Father of All Monks, was a Christian saint from Egypt, a prominent leader among the Desert Fathers. He is celebrated in many churches on his feast days: 17 January in the Eastern Orthodox Church and Western churches; and Tobi 22, (January 30) in the Coptic Orthodox Church and the Coptic Catholic ChurchSt.
Anthony was a third century Egyptian ascetic, who lived an unblemished life in the desert near the Red Sea, fasting for long periods, which was probably the reason for the visions and temptations he is said to have experienced. He believed them to be the work of the devil, and resisted steadfastly. In his own lifetime, Anthony had no direct connection with ergotism, however his name was taken by an Order of Hospitallers, founded in France about 1100. The Hospitallers, wearing black robes embroidered with blue crosses, travelled widely across medieval Europe, ringing little bells to attract alms, and the hospitals they thus funded became pilgrimage centres for sufferers from ergotism.6 The Antonite monks were credited with many cures, and thus Anthony's name and life story became attached to the disease. What were said to be the saint's bones were sprinkled with holy water or wine, which was then drunk by the afflicted; however it seems more likely that cures were related to the Hospitallers providing a diet free from contaminated grain. Amputated limbs were frequently left at the sites of shrines to St Anthony as offerings of thanks and evidence of the saint's success

Read more in Lancet. 2002 May 18;359(9319):1768-70.St Anthony's fire and living ligatures: a short history of ergometrine.
De Costa C.

Wiki tells me that erysepelas and zoster are also some times called St Anthony's Fire

Image: temptation of St Anthony/ Dali

Riva Rocci

The cuff sphygmomanometer was invented by Italian physician Scipione Riva-Rocci in 1896. (Scipione Riva-Rocci (7 August 1863 — 15 March 1937) was an Italian internist and pediatrician who was a native of Almese. He earned his medical degree in 1888 from the University of Turin, and from 1900 until 1928 was director of the hospital in Varese.)This simple device caught the eye of US surgeon Harvey Cushing, who believed he could use it in the measurement of BP, which would be useful in his ongoing studies of cerebral perfusion. Cushing introduced this instrument at Johns Hopkins Hospital. Early supporters of this new method of BP measurements were Theodore Janeway in New York City and George Crile in Cleveland, OH. After only 2 years of experience on the wards of Johns Hopkins Hospital, Cushing and his surgical house officers set out to promote wider use of the cuff. This was the foundation for the use of BP measurements in epidemiologic studies and for controlled clinical trails of antihypertensive agents, which have so dramatically reduced the socioeconomic impact of heart attack and stroke in the last 25 years. Contrast the history of spirometry with that of the development and widespread application of the sphygmomanometer, invented 50 years after the spirometer.

John Hutchinson’s Mysterious Machine

John Hutchinson, a surgeon, recognized that the volume of air that can be exhaled from fully inflated lungs is a powerful indicator of longevity. He invented the spirometer to measure what he called the vital capacity, ie, the capacity to live. Much later, the concept of the timed vital capacity, which became known as the FEV1, was added. Together, these two numbers, vital capacity and FEV1, are useful in identifying patients at risk of many diseases, including COPD, lung cancer, heart attack, stroke, and all-cause mortality. This article cites some of the rich history of the development of spirometry, and explores some of the barriers to the widespread application of simple spirometry in the offices of primary care physicians.

John Hutchinson, a surgeon, invented a calibrated bell, inverted in water, in order to be able to capture and measure the volume of exhaled air from fully inflated lungs. He coined the term vital capacity, ie, the capacity for life, because he realized that compromise of this crucial measurement was predictive of premature mortality. His exacting observations taught him that in normal subjects, the vital capacity was directly related to the height, and inversely related to the age of the individual. Weight had only a minor effect on the vital capacity, but he observed that vital capacity became mildly reduced following a large meal.1 In his first article published in 1846, he reported on measurement of 2,130 individuals, including deceased patients .Hutchinson would go to the morgue immediately following death, insert into the trachea the equivalent of an endotracheal tube with a stopcock, and inflate the corpse with a bellows until no more air could enter. He then released the flow of air into his spirometer by opening the stopcock. The lungs and thorax emptied through elastic recoil. Of course, this was not the full FVC, but something very close to it. The lungs emptied to their minimum volume, a function of the residual volume. In this era, tuberculosis was rampant in Europe. Hutchinson recognized that fibrotic complications from tuberculosis resulted in a reduced vital capacity and early death. Similar observations were made in heart failure and in coal miners.2

Hutchinson was a handsome young man . He had a keen ear for music and became a master violinist. Hutchinson became a consultant to the insurance industry of London. He believed that the vital capacity should be used in actuarial predictions for persons selling life insurance. Hutchinson’s invention was initially acclaimed:
…we have no hesitation in recording our deliberate opinion, that it forms one of the most valuable contributions to physiologic science that we have met with for some time. In all future investigations into the phenomena of the respiratory process, the name of Mr. Hutchinson must receive honorable notice.2

Hutchinson’s instrument was not widely accepted in London, or anywhere else, and still remains absent from most physicians’ offices and clinics. This may be one of the reasons why John Hutchinson was frustrated when he left his wife and three children and emigrated to Melbourne, Australia at 41 years of age.

He may have been in search of gold, since a gold strike had just been made in Australia. Another speculation is that he had tuberculosis and sought the cure of a prolonged ocean voyage with abundance of fresh air and sunshine, which was a common method of seeking the cure for tuberculosis in that era.2 Other speculations over alcohol abuse were made.2 After he reached Australia, he abandoned all further use of his spirometer. Toward the end of his life he moved to Fiji, where he died at 50 years of age, probably a victim of murder.2 His autopsy showed no signs of tuberculosis, nor did it explain his demise.5 No evidence of liver disease was found at autopsy.2

A statue was erected to the memory of John Hutchinson by the Thoracic Society of Australia and the British Thoracic Association in 1990 . It can be viewed by visitors to Fiji.

For details read the full article John Hutchinson’s Mysterious Machine Revisited*
Thomas L. Petty, MD, Master FCCP in the CHEST Journal
http://chestjournal.chestpubs.org/content/121/5_suppl/219S.full
CHEST May 2002 vol. 121 no. 5 suppl 219S-223S

Flexner Report

The 1910 report that revolutionized medical education and established current system of education.

The Flexner Report is a book-length study of medical education in the United States and Canada, written by the professional educator Abraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Many aspects of the present-day American medical profession stem from the Flexner Report and its aftermath.

The Report (also called Carnegie Foundation Bulletin Number Four) called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research. Many American medical schools fell short of the standard advocated in the Report, and subsequent to its publication, nearly half of such schools merged or were closed outright. The Report also concluded that there were too many medical schools in the USA, and that too many doctors were being trained. A repercussion of the Flexner Report resulting from the closure or consolidation of university training, was reversion of American universities to male-only admittance programs to accommodate a smaller admission pool. Universities had begun opening and expanding female admissions as part of women's and co-educational facilities only in the mid-to-latter part of the 19th century with the founding of co-educational Oberlin College in 1833 and private colleges such as Vassar College and Pembroke College.

John Snow and the 1854 Broad Street Cholera Outbreak

Many historians trace modern public health and epidemiology to the day in 1850s when Dr. John Snow, having discerned the link between cholera outbreaks in London and water sources used by the afflicted populace, removed the handle of the Broad Street water pump. Thus one cholera epidemic was stopped, but it would still be years before the etiology of cholera was discovered.

In the mid-19th century, the Soho district of London had a serious problem with filth due to the large influx of people and a lack of proper sanitary services. Many cellars (basements) had cesspools of nightsoil underneath their floorboards. Since the cesspools were overrunning, the London government decided to dump the waste into the River Thames. This action contaminated the water supply, leading to the cholera outbreak.


Outbreak
On 31 August 1854, after several other outbreaks had already occurred elsewhere in the city, a major outbreak of cholera struck Soho. Dr Snow later called it "the most terrible outbreak of cholera which ever occurred in the kingdom."

Over the next three days 127 people on or near Broad Street died. In the next week, three quarters of the residents had fled the area. By 10 September, 500 people had died and the mortality rate was 12.8 percent in some parts of the city. By the end of the outbreak 616 people died.

Snow was a skeptic of the then-dominant miasma theory that stated that diseases such as cholera or the Black Death were caused by pollution or a noxious form of "bad air". The germ theory was not widely accepted by this time, so Snow was unaware of the mechanism by which the disease was transmitted, but evidence led him to believe that it was not due to breathing foul air. He first publicized his theory in an essay On the Mode of Communication of Cholera in 1849. In 1855 a second edition was published, with a much more elaborate investigation of the effect of the water-supply in the Soho, London epidemic of 1854.

By talking to local residents (with the help of Reverend Henry Whitehead), he identified the source of the outbreak as the public water pump on Broad Street (now Broadwick Street). Although Snow's chemical and microscope examination of a sample of the Broad Street pump water was not able to conclusively prove its danger, his studies of the pattern of the disease were convincing enough to persuade the local council to disable the well pump by removing its handle. Although this action has been popularly reported as ending the outbreak, the epidemic may have already been in rapid decline, as explained by Snow himself:

Snow later used a spot map to illustrate how cases of cholera were centred around the pump. He also made a solid use of statistics to illustrate the connection between the quality of the source of water and cholera cases. He showed that the Southwark and Vauxhall Waterworks Company was taking water from sewage-polluted sections of the Thames and delivering the water to homes with an increased incidence of cholera. Snow's study was a major event in the history of public health, and can be regarded as the founding event of the science of epidemiology.

The first Heart Transplant

He performed the world's first human heart transplant operation on 3 December 1967, in an operation assisted by his brother, Marius Barnard; the operation lasted nine hours and used a team of thirty people. The patient, Louis Washkansky, was a 54-year-old grocer, suffering from diabetes and incurable heart disease. Barnard later wrote, "For a dying man it is not a difficult decision because he knows he is at the end. If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water, convinced you have a chance to swim to the other side." The donor heart came from a young woman, Denise Darvall, who had been killed in a December 2, 1967, road accident while crossing a street in Cape Town. After securing permission from Darvall's father to use her heart, Barnard performed the transplant. Twenty years later, Dr. Marius Barnard recounted, "Chris stood there for a few moments, watching, then stood back and said, 'It works.'"[3][who?] Washkansky survived the operation and lived for eighteen (18) days. However, he succumbed to pneumonia induced by the Immunosuppressive drugs he was taking. Though the first patient with the heart of another human being survived for only a little more than two weeks, Barnard had passed a milestone in a new field of life-extending surgery.

Barnard became an international superstar overnight and was celebrated around the world for his daring accomplishment. He was quite photogenic, and enjoyed the media attention following the operation. Barnard continued to perform heart transplants. A transplant operation was conducted on 2 January 1968, and the patient, Philip Blaiberg, survived for 19 months. Dorothy Fisher was given a new heart in 1969 and became the first black recipient. She lived for 12 years 6 months after the transplant.[4] Dirk van Zyl, who received a new heart in 1971, was the longest-lived recipient, surviving over 23 years.[5]

Barnard performed ten orthotopic transplants (1967 – 1973). He was also the first to perform a heterotopic heart transplant, an operation that he himself devised. Forty-nine consecutive heterotopic heart transplants were performed in Cape Town between 1975 and 1984.

When many surgeons — disillusioned by poor results — gave up cardiac transplantation, Barnard persisted until the advent of cyclosporin, which helped revive the operation throughout the world. He was also the first surgeon to attempt xenograft transplantation in a human patient, while attempting to save the life of a young girl unable to leave artificial life support after a second aortic valve replacement. He was later accused of wrongdoing by her parents.

After his first successful heart transplant Barnard became known as the "film star surgeon". He was loved by his patients throughout the world, hundreds of whom were treated free of charge, and hated by many others who were jealous of his instant success. He was accused by some colleagues in the profession of "stealing" the idea and the opportunity to perform the first heart transplant. Often considered a spoiled and arrogant personality, he was also regarded as kind and considerate by others. Due to his widely publicized love affairs, he became jokingly known as "doctor of hearts", referring to the heart as emotional symbol rather than in its usual medical context.

Barnard was an outspoken opponent of South Africa's laws of apartheid, and was not afraid to criticize his nation's government, although he had to temper his remarks to some extent in order to travel abroad. Rather than leaving his homeland, he used his fame in order to campaign for a change in the law. After Denise Darvall provided the means for the very first heart transplant, Barnard transplanted her kidney into a 10-year-old coloured boy. The donor for the second heart transplant was also coloured. Christiaan's brother, Dr. Marius Barnard, went into politics, and was elected to the legislature on an anti-apartheid platform. However, Barnard later claimed that the reason he never won the Nobel Prize in Physiology or Medicine was probably because he was a "white South African".

Intra Aortic Ballon Pump

This story may be apocryphal, but here it goes. In the late 1960s, the intra-aortic balloon pump (IABP) was being readied for its first use in a human.(The IABP device was pioneered at the Grace-Sinai Hospital in Detroit during the early 1960s by Dr. Adrian Kantrowitz) Its developers thought that private insurance companies would not stand for such a radical new therapy, and approached the military, asking them to keep an eye out for IABP candidates in military hospitals.
One day, the call came. A retired general was hospitalized in Walter Reed Army Medical Center. He had a history of multiple infarcts and was now end-stage. The IABP scientists were all ready to go, until they found out the general was Eisenhower. They declined the opportunity because they worried that if the IABP failed in him, it would permanently ruin the future prospects of the device.

Eosinophilia-Myalgia syndrome (EMS),

EMS was first recognized in 1989 in New Mexico. Three women sought medical help for a mysterious, undiagnosable condition presenting with marked peripheral blood eosinophilia and severe myalgia, followed by the development of scleroderma-like chronic skin lesions. It was eventually discovered that all of the women had one thing in common: they had been taking L-tryptophan, a health food supplement sold as a sleep aid.


The tainted product was traced back to Showa Denko Inc, a Japanese company, that had been cutting corners in their purification procedure to reduce their manufacturing costs. Additionally, they were experimenting with genetically engineered bacteria in order to accelerate and increase the efficiency of their production process. As a result, contaminated batches of L-tryptophan were placed on the market. Within three months, 37 people died and over 1500 were permanently disabled from using this product.


About a decade back, a similiar epidemic of a novel syndrome with features suggestive of SSc had occurred in Spain in the 1980s. The outbreak, termed toxic oil syndrome and affecting over 20,000 individuals, was linked to consumption of contaminated rapeseed oils used for cooking

Scrofula - King's Evil

In the Middle Ages it was believed that "royal touch", the touch of the sovereign of England or France, could cure diseases because sovereigns were appointed by the Divine. Scrofula was therefore also known as the King's Evil. The kings were thought to have received this power due to their descent from Edward the Confessor, who, according to some legends, received it from Saint Remigius. From 1633, the Book of Common Prayer of the Anglican Church contained a ceremony for this, and it was traditional for the monarch (king or queen) to present to the touched person a coin —usually an Angel, a gold coin the value of which varied from about 6 shillings to about 10 shillings. King Henry IV of France is reported as often touching and healing as many as 1,500 individuals at a time.

Queen Anne touched the infant (later Doctor) Samuel Johnson in 1712, but King George I put an end to the practice as being "too Catholic". The kings of France continued the custom until Louis XV stopped it in the 1700s, though it was briefly revived to universal derision in 1825