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.

Charles Richard Drew and Blood Transfusion

Charles Richard Drew (3 June 1904 – 1 April 1950) was an African-American physician, surgeon and medical researcher. He researched in the field of blood transfusions, developing improved techniques for blood storage, and applied his expert knowledge to developing large-scale blood banks early in World War II. This allowed medics to save thousands of lives of the Allied forces. The research and development aspect of his blood storage work is disputed. Drew protested against the practice of racial segregation in the donation of blood, as it lacked scientific foundation, an action which cost him his job. In 1943, Drew's distinction in his profession was recognized when he became the first black surgeon selected to serve as an examiner on the American Board of Surgery.

In late 1940, during World War II before the US entered the war, and just after earning his doctorate, Drew was recruited by John Scudder to help set up and administer an early prototype program for blood storage and preservation. He was to collect, test, and transport large quantities of blood plasma for distribution in Great Britain. Drew went to New York to direct the United States' Blood for Britain project. The Blood for Britain project was a project to aid British soldiers and civilians by giving US blood to Great Britain.

Drew created a central location for the blood collection process where donors could go to give blood. He made sure all blood plasma was tested before it was shipped out. He ensured that only skilled personnel handled blood plasma to avoid the possibility of contamination. The Blood for Britain program operated successfully for five months, with total collections of almost 15,000 people donating blood, and with over 5,500 vials of blood plasma. As a result, the Blood Transfusion Betterment Association applauded Drew for his work

James Lind and Scurvy

Lind was a Scottish doctor, a pioneer of naval hygiene and expert on the treatment of scurvy. . By conducting the first ever clinical trial,  he developed the theory that citrus fruits cured scurvy

James Lind was born in Edinburgh in 1716. In 1731, he registered as an apprentice at the College of Surgeons in Edinburgh and in 1739 became a surgeon's mate, seeing service in the Mediterranean, Guinea and the West Indies, as well as the English Channel. In 1747, while serving as surgeon on HMS Salisbury, he carried out experiments to discover the cause of scurvy, the symptoms of which included loose teeth, bleeding gums and haemorrhages.

Lind selected 12 men from the ship, all suffering from scurvy, and divided them into six pairs, giving each group different additions to their basic diet. Some were given cider, others seawater, others a mixture of garlic, mustard and horseradish. Another group of two were given spoonfuls of vinegar, and the last two oranges and lemons. Those fed citrus fruits experienced a remarkable recovery. While there was nothing new about his discovery - the benefits of lime juice had been known for centuries - Lind had definitively established the superiority of citrus fruits above all other 'remedies'.

In 1748, Lind retired from the navy and went to Edinburgh University to take professional qualifications. In 1753, he published 'A Treatise of the Scurvy' and in 1757 'An Essay on the Most Effectual Means of Preserving the Health of Seamen in the Royal Navy', which threw much light on the appalling living conditions and diet of seamen. In 1758, he was appointed physician to the Naval Hospital at Haslar in Gosport where he investigated the distillation of fresh water from salt water for supply to ships.

In 1763, Lind published work on typhus fever in ships and in the 1768 publication 'An Essay on Diseases Incidental to Europeans in Hot Climates' he summarised the prevalent diseases in each colony and gave advice on avoiding tropical infections. Lind died in 1794 in Gosport.

Although the importance of Lind's findings on scurvy were recognised at the time, it was not until more than 40 years later that an official Admiralty order was issued on the supply of lemon juice to ships. With this, scurvy disappeared almost completely from the Royal Navy.

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

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.

Egerton Yorrick Davis and Penis Captivus

The term penis captivus describes a relatively rare medical condition in which a woman's vaginal muscles uncontrollably spasm during intercourse, trapping her partner's penis inside her vagina. The only solution to such a problem is to administer muscle relaxants to the female in question, thereby alleviating the spasms and effecting a penile escape. Case studies of penis captivus have been documented in reputable medical literature. Really.

However, this condition does not actually exist.

In reality, penis captivus started out as an elaborate hoax perpetrated by a playful physician in the late 19th century. During this time period, sexology and the study of sexual dysfunction was just beginning to come into vogue with the work of pioneers like Richard von Krafft-Ebing and later, Havelock Ellis. Of particular interest was the condition known as vaginismus, in which the muscles of the vaginal wall uncontrollably contract, making sexual penetration either very painful or physically impossible. On December 4, 1884, the Philadelphia Medical News published a letter from an ex-Army physician named "Egerton Y. Davis" which purported to describe an actual case study of a rare form of vaginismus called penis captivus (or alternatively, de cohesione in coitu). Until this point, the condition had existed as a purely hypothetical situation.

Dr. Davis recounts an unusual house call he made late one night to the home of a well-to-do patient. When Davis arrived, the gentleman explained that his coachman required the doctor's services. Allegedly, the master of the house, whilst investigating strange noises coming from the servants' quarters, had inadvertently stumbled upon the coachman and the downstairs maid mid-coitus. The maid was so surprised at the interruption that her entire body, including her vagina, just locked up. As she was apparently a very small woman, these muscular contractions held the coachman's penis in place, and no amount of pushing or pulling could disengage the couple. After several abortive attempts to use ice and lubricant to solve the problem, the good doctor dosed the woman with chloroform to relax her muscles and free the hapless coachman.

Davis goes on to describe the coachman's penis as semi-erect and extremely swollen near the top of the shaft and the glans. He admits that he did not examine the maid's genitals or anus before attempting the extraction, but suggests that sudden contraction of both her anal sphincter and the muscles in her vaginal wall had constricted the flow of blood to and from her partner's member, causing his penis to become abnormally engorged near the top and creating a "lock and key" situation. The letter concludes by quoting the infamously raunchy line from Shakespeare's Othello, along with theorizing that the biblical story of Phinehas could be explained through the penis captivus phenomenon (With a single javelin thrust, Phinehas simultaneously killed a man and a woman who had engaged in the sinful act of whoredom).

A week before receiving the letter, the Philadelphia Medical News had published an article detailing several different forms of vaginismus and suggesting that penis captivus might be physiologically possible. Thus, the journal was eager to print Dr. Davis' case study as a followup to the previous article, and did not check the veracity of the letter before publication. This oversight is understandable, as it probably would have taken a week or two to confirm the case study (at the time, communication by telegraph was limited, and the telephone was still a new invention). However, the journal never bothered to check out Davis' story even after the letter was published (one would think that someone would have requested more information).

There are several aspects of the letter that make the case study rather questionable. By today's standards, it is anecdotal at best. There are few specific details about the patients, other than a brief mention that the maid probably weighed less than 90 pounds. Dr. Davis seems more concerned with making witty literary allusions than relaying pertinent medical information. Finally, the geography of the letter doesn't quite match up. When signing the letter, Egerton Y. Davis wrote "Ex U.S. Army" after his name, states in the body of the letter that his practice is located in England, and originally sent the piece to The Canada Medical and Surgical Journal, which then forwarded it to Philadelphia Medical News. Despite these inconsistencies, Dr. Davis' informal case study was held as incontrovertible proof of the existence of penis captivus for nearly a century. It was referenced in numerous urology and sexology textbooks and medical articles.

As it turns out, there was no such person as Egerton Y. Davis. The name was a pseudonym for Sir William Osler, who served on the editorial board for the Philadelphia Medical News. Generally speaking, Osler was a staunch believer in scientific research, which ironically led him to submit the fallacious case study. The article on vaginismus that had been published the previous week was written anonymously by fellow board member Theophilius Parvin. Osler felt that Parvin had inserted too much editorial commentary and neglected medical facts when writing the article. Therefore, he devised a little prank to play on his colleague. Osler wrote the letter from Davis, forged an accompanying letter from the editor of The Canada Medical and Surgical Journal, and had a friend mail both documents from Montreal in order to obtain a legitimate Canadian postmark. Osler figured that, after the false case study was published, surely someone would recognize it for what it was, greatly embarrassing Parvin (as he was the one who decided to publish the letter as a followup to his own article) and eliciting a hearty round of laughter from the rest of the journal's staff. Much to Osler's chagrin, the medical community bought into the idea of penis captivus hook, line and sinker.

Egerton Yorrick Davis was a known pseudonym (and somewhat of an alter ego) that Osler used on multiple occasions, a fact that is well documented in his biography The Life of Sir William Osler, written by Harvey Cushing and first published in 1925. Osler carried the secret of the penis captivus debacle to his grave (he passed away in 1919), and Cushing either didn't make the connection or chose to allow Osler's hoax to continue. It wasn't until the early 1970s that physicians, curious as to why there are no documented cases of penis captivus after the 1884 letter, dug into the matter and discovered the prank.

Nowadays, most members of the medical community discount the theory of penis captivus as implausible, if not impossible. Vaginismus is a physical manifestation of a psychological condition (usually because a woman has been sexually abused in her past), and invariably occurs before penetration, not during intercourse. A few physicians (who are in a distinct minority) believe that penis captivus may be possible, but if so, the condition would certainly cease to be a problem after the man loses his erection. To this day, Osler's prank continues to live on in the form of urban legend.

Interestingly, a phenomenon similar to penis captivus does occur in other species, namely canids (such as dogs and wolves). The males of these species have a penis with a particularly bulbous head compared to human males. Due to this bulbous structure, a mating male and female may remain locked together in the copulatory position for as long as 10-20 minutes after ejaculation. This is probably an evolutionary mechanism to prevent the female from immediately running off and mating with another male.

Read more at http://everything2.com/title/penis+captivus

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

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

William Chester Minor

William Chester Minor, also known as W. C. Minors was an American surgeon who made many scholarly contributions to the Oxford English Dictionary while confined to a lunatic asylum.

William Chester Minor ( June 1834 - March 26 1920) was born on the island of Ceylon, the son of Congregationalist Church missionaries from New England. He is known to have been fascinated as a teenager by the young Ceylonese girls and to have had lascivious thoughts which plagued his conscience. At 14 he was sent back to the United States by steamship, finishing his education as a surgeon at Yale in New Haven, Connecticut in 1863.
He was accepted by the Union Army as a surgeon and saw service at the Battle of the Wilderness in May, 1864. This was a battle that was notable for the horrible casualties suffered. He was ordered as a surgeon to brand an Irish deserter, a member of the Fenian Brotherhood, on the face. Paranoid delusions about the Fenians, Irish revolutionaries, were part of his later madness.

After the end of the American Civil War Minor saw duty in New York City. He was strongly attracted to the fleshpots of the city and devoted much of his off-duty time spending time with prostitutes. By 1867, his bizarre behavior had come to the attention of the Army and he was transferred to a remote post in the Florida Panhandle. By 1868 his disease had progressed to the point that he was admitted to St. Elizabeth's Hospital, a lunatic asylum in Washington, DC. After eighteen months he showed no improvement. He was allowed to resign his commission and take retirement pay.

In 1871 he went to London, England settling in the slum of Lambeth where once again he took up a dissolute life. Haunted by his paranoia he shot a man he believed had broken into his room. He was judged innocent by reason of insanity and incarcerated in the aslyum at Broadmoor in the village of Crowthorne, Berkshire. As he had his army pension and was not judged dangerous, he was given rather nice quarters and was able to buy and read books.

It was probably through his correspondence with the London booksellers that he heard of the call for volunteers from what was to become the Oxford English Dictionary. He devoted the remainder of his life to that work.

He was one of the most effective of the volunteers, systematically reading through his library, and compiling lists of the occurrence of words. He kept current with the words needed in the volume currently being worked on, and as his lists grew was able to supply quotations on demand for a particular word. Eventually he became well acquainted with the editor of the OED, Dr. James Murray, who visited him at the asylum and befriended him. In time Minor's condition grew worse; his health failed and he was permitted to return to the United States and St. Elizabeth's. Psychiatry had progressed in the meantime and Dr. Minor was diagnosed as suffering from dementia praecox or schizophrenia. He died in 1920 in New Haven, Connecticut.

The 2009 Nobel Prize in Physiology or Medicine

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Nobel Prize 2008 - HIV & HPV

Harald zur Hausen went against current dogma and postulated that oncogenic human papilloma virus (HPV) caused cervical cancer, the second most common cancer among women. He realized that HPV-DNA could exist in a non-productive state in the tumours, and should be detectable by specific searches for viral DNA. He found HPV to be a heterogeneous family of viruses. Only some HPV types cause cancer. His discovery has led to characterization of the natural history of HPV infection, an understanding of mechanisms of HPV-induced carcinogenesis and the development of prophylactic vaccines against HPV acquisition.

Françoise Barré-Sinoussi and Luc Montagnier discovered human immunodeficiency virus (HIV). Virus production was identified in lymphocytes from patients with enlarged lymph nodes in early stages of acquired immunodeficiency, and in blood from patients with late stage disease. They characterized this retrovirus as the first known human lentivirus based on its morphological, biochemical and immunological properties. HIV impaired the immune system because of massive virus replication and cell damage to lymphocytes. The discovery was one prerequisite for the current understanding of the biology of the disease and its antiretroviral treatment

Small pox

A quarter of a century has gone by since the last natural case of smallpox anywhere in the world. Ali Maow Maalin, a cook at the hospital in Merca, Somalia, and sometime vaccinator in a World Health Organisation eradication team, developed his rash on 27 October 1977. After this final hiccup smallpox joined the dodo and the dinosaur as life-forms extinct in the natural world.


Maalin was lucky: his case was mild. To be absolutely certain that the world was smallpox-free, surveillance went on for two years after his illness. There were no more ‘natural’ cases and on 8 May 1980, Resolution WHA33.3 was signed at the eighth plenary meeting of the 33rd World Health Assembly. It declared that ‘the world and all its people’ had ‘won freedom from smallpox . . . which only a decade ago was rampant in Africa, Asia and South America’.

Smallpox was only extinct by resolution and in ‘nature’, however. It lived on in laboratories in frozen form. It still does. There is currently concern that some of it may have fallen into the wrong hands. Laboratory stocks of smallpox are just as malevolent as their natural counterparts. The last human smallpox infections anywhere in the world were contracted from such stocks and occurred not in Africa, Asia or South America, but in England.


1978 Henry Bedson was professor of medical microbiology at Birmingham University. His father, Sir Samuel, had also been a microbiologist, whose work on psittacosis had been recognised by a proposal to call the group of organisms to which it belonged Bedsonia. Henry Bedson had been trained as a virologist by the doyen of British smallpox experts, Allan Downie of Liverpool University

The WHO had told Henry Bedson that his application for his lab to become a Smallpox Collaborating Centre had been rejected. This meant that in the fairly near future his lab’s work on the virus would have to stop. The WHO wanted as few sites as possible handling the virus. They had acceded, however, to his request to continue research until the end of 1978. Their safety inspectors would visit. Henry faced a dilemma. He wanted to finish his current research programme, which was significantly advancing our understanding of smallpox viruses. But Henry was also aware that the laboratory would fail the forthcoming WHO safety inspection and that there would be no money for an upgrade because of its imminent closure. Smallpox work continued in Birmingham, but the WHO inspectors were unhappy. Correspondence started with Geneva about safety problems. Although Bedson’s laboratory was not state of the art, it was a lot better than it had been. So Bedson gambled. To finish the project in time the pace of work intensified, and more and more virus strains were cultured. But the bet failed, disastrously.
On Friday, 11 August, Janet Parker, a medical photographer in the Anatomy Department, which was located directly above the poxvirus laboratory, developed a headache and muscular pains. Her husband had to drive her to work. On Saturday she felt better and went for a walk, and on Sunday she called on a neighbour, although she began to feel ill again. On Tuesday she developed spots. On Wednesday her GP prescribed an antibiotic. It was stopped on Friday because it was thought to be causing the rash. More spots developed and she went to stay with her parents. On the following Thursday, 24 August, she was admitted to hospital. Smallpox was suspected, and it was confirmed by electron microscopy of fluid from her rash. At 10 p.m. that night she was moved to the Catherine-de-Barnes smallpox hospital, where she died on 11 September. Mrs Parker had been joined there by her mother who, despite being vaccinated on 24 August, developed smallpox on 7 September. She recovered. On 6 September, after the Government announced an investigation into the outbreak, Henry Bedson went into the shed at the bottom of his garden and cut his throat.

The investigation concluded that Mrs Parker had probably been infected by a strain of smallpox called Abid (after one of its earlier victims, a three-year-old Pakistani boy), which was being handled in the smallpox laboratory on 24 and 25 July. The virus had travelled in air currents up a service duct from the laboratory below to a room in the Anatomy Department which was used for telephone calls; on 25 July Mrs Parker had spent much more time there than usual ordering photographic materials because the financial year was about to end.

Courtesy: Small Pox scares, Hugh Pennington http://www.lrb.co.uk/v24/n17/penn01_.html

Elizabeth Blackwell

Portrait of Elizabeth Blackwell, the first ever woman doc
Syracuse University Medical School collection