THE SIGNIFICANCE OF FOREIGN CONTRIBUTIONS TO PRESENT KNOWLEDGE IN GENERAL MEDICAL SCIENCE

CLASSIC CONTRIBUTIONS

The Father of Medicine.-Hippocrates (460-377 B. C.), Greek physician, is called the father of medicine. This man, who is considered by many to be the greatest of the great classical physicians, wrote voluminously on epidemics, fevers, epilepsy, fractures, health in general, and medical ethics. Today, as they have done throughout the centuries, physicians in nearly all countries subscribe to the Oath of Hippocrates.

The First Widespread Text in Medicine.-Avicenna (980-1037) of Persia, the most illustrious physician in Arabian medicine, codified the whole of medical knowledge up to his time. This work, the Canon, was translated into Latin and became the authoritative medical textbook in Europe for six centuries. It is still considered infallible in Islam.

Early Observations on Anemias.-Johannes Lange (1485-1565), one of the most highly esteemed physicians of the 16th Century, received his M. D. degree in Pisa in 1522. He continued to study and practice in various countries of Europe, and in 1554 published a treatise on nutritional anemias, one of the first such writings known. Interestingly, he prescribed marriage as a means of curing young girls afflicted with such anemias, this circumstance apparently awakening the victim's interest in food.

First Great Anatomist.-Andreas Vesalius (1514-1564) of Brussels, issued his masterpiece of anatomy, De Humanis Corporis Fabrica, at Basel in 1543, containing illustrations which were executed in the workshop of the master painter Titian. This volume, together with its companion, Epitome, remains paramount among the centuries' products in descriptive anatomy.

First Man to See Bacteria.-Anton van Leeuwenhoek (1632-1723), pioneer Dutch microscopist, was the first actually to see single-cell organisms such as bacteria, and gave the first accurate description of the red blood cell.

Early Description of Liver Disease.-John Brown (1642-1700), who came of a long line of English surgeons, was trained at St. Thomas's Hospital, London. He served as surgeon to Charles II and later to William III. Brown described quite accurately the disease entity known as cirrhosis (hardening) of the liver. The actual name cirrhosis was applied 100 years later by Laënnec.

First Clear Description of Pellagra.-Gaspar Casal (1679-1759), known as the "Spanish Hippocrates," practiced medicine in Madrid. In 1751 he was appointed physician to King Ferdinand. Casal wrote the first clear description of pellagra (niacin deficiency) in 1735,

applying the name "mal de la Rosa" to the condition. The name derives from the reddish hue which is assumed by areas of the skin of pellagrous individuals.

First Good Study of Digestion.-Lazaro Spallanzani (1729-1799), Italian physiologist, demonstrated for the first time that the secretions of the stomach have the ability to dissolve meat, using a buzzard as his experimental subject. For research equipment, Spallanzani used a piece of meat on a string. Studies of the processes of digestion soon became widespread, due to Spallanzani's pioneer discoveries.

First Experimental Pathologist.-John Hunter (1728-1793), Scottish surgeon in England, contributed much toward the development of experimental pathology, and wrote a classic description of inflammation in 1794. His experimental subjects were persons suffering with gunshot wounds.

Together with his brother, William, John Hunter established a school of anatomy; and one of his students, Edward Jenner (1749– 1823), later discovered the means of vaccinating against smallpox.

A medical museum containing many well-preserved examples of diseased organs prepared by Dr. Hunter is still maintained in London, and may be visited today.

NINETEENTH AND TWENTIETH CENTURY LANDMARKS

The First Stethoscope.-René Laennec (1781-1826) received his M. D. at the Charité Hospital, Paris, in 1804. He invented the stethoscope in 1816, an achievement which assured the immortality of his name. Laennec's original stethoscope was a roll of paper, which later developed into a hollow wooden cylinder. Laennec, who devoted much of his professional life to the study of patients with chest disease, died of tuberculosis.

The Childbed Fever Problem.-Ignaz Semmelweis (1818-1865), obstetrician in Vienna, was the first to recognize that the prevailing 50 percent death rate of women hospitalized for childbirth was due to bacterial contamination by the unwashed hands of attending physicians. His fellow physicians, slow to recognize his discovery, so derided and persecuted Semmelweis that he committed suicide. In later years hygienic practices based upon the writings of Semmelweis decreased the deaths from childbed fever to less than 1 percent.

First Geneticist.-Greger Johann Mendel (1822-1884), an Austrian monk and scientist, discovered the fundamental principles governing inheritance of characteristics passed on by parents to offspring. Comprehension of such diseases as hemophilia rests to a large degree on an understanding of Mendelian genetics.

X-Rays.-Wilhelm K. Roentgen (1845-1923), German scientist, discovered X-rays in 1895, and laid the foundation for the science of radiology. He was awarded a Nobel prize for this work in 1901.

Science of Body Salts.-Svante A. Arrhenius (1859-1927), of Sweden, developed the theory which describes the existence of electrically charged particles in solution. For this he was awarded a Nobel prize in 1903, and from his theory developed the basis for modern fluidand salt-balance therapy used in practically all hospitals throughout the world.

Vitamins. Frederick G. Hopkins (1861-1947), of England, predicted the discovery of vitamins in 1906, and as a result of isolating some growth-promoting substances at this early date was awarded a Nobel prize in 1929.

Founders of the Science of Radiation.-Marie Curie (1867-1934), working in France with her husband Pierre and Henri Becquerel, discovered radium in 1898. These three scientists received a Nobel award for work on radioactivity in 1903, and later Marie Curie received another Nobel award in 1911. Radium therapy has found an established place in modern medicine, and the new field of radioisotopes is just now coming into its own.

Safe Blood Transfusions.-Karl Landsteiner (1868-1943), American, established in 1900 the basis for classifying blood into groups, and with Alexander Wiener discovered the Rh factor in 1940. For the original work on blood groups, Dr. Landsteiner received the Nobel prize in 1930. The methods he devised for typing blood are in universal use today, and are saving untold millions of lives.

Insulin and Sugar Diabetes.-Frederick Banting (1891-1941), Canadian, together with John McLeod (1876-1935), discovered insulin in 1922. As a result, millions of diabetics are afforded a reasonably normal life. These two men were awarded a Nobel prize in 1923.

PRESENT FOREIGN RESEARCH OF GREAT PROMISE IN THE FIELD
OF GENERAL MEDICINE

Belgium. Dr. Corneille Heymans (Nobel laureate, 1938), University of Ghent, 3, Albert Baertsoenkaai, Ghent; fundamental research on respiration.

England.-Dr. Watson Crick, Cambridge University; studies on the basic structure of cell proteins.

Dr. Hans Krebs (Nobel laureate, 1953), Department of Biochemistry, Oxford; fundamental metabolism research.

Dr. A. T. Welford, Psychological Laboratory, Cambridge University; psychological studies on aging industrial workers.

France. Dr. F. Bourlière, Claude Bernard Center of Gerontology, Paris; comparative zoologic studies in aging.

Dr. Latarget, Director of Pasteur Institute, Paris; studies on effects of radiation on living matter.

Germany. Dr. Adolf Butenandt (Nobel laureate, 1939), Max Planck Institute for Biochemistry, Munich; isolated, identified, and synthesized the sex hormones; has pioneered the field of chemical genetics.

Dr. Gerhard Domagk (Noble laureate, 1939), I. G. Farben Laboratory, Elberfeld; studies on biochemistry of metabolism.

Dr. Gunther Lehmann, Max Planck Institute for Physiology of Work, Dortmund; studies on effects of aging and other factors on work capacity in the Ruhr mining district.

Dr. Max Schneider, Institute of Physiology, University of Cologne, Cologne; studies on cell and tissue metabolism.

Gerhard Schramm, Max Planck Institute for Virus Research, Tuebingen; fundamental studies on metabolism.

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Otto Warburg (Nobel laureate, 1931), Max Planck Institute for Cell Physiology, Berlin Dahlem; studies on the chemistry of cell respi

ration.

Holland. Dr. J. Groen, Wilhelmina Gasthuis, Amsterdam; aging and nutrition studies.

Sweden. Hans von Euler (Nobel laureate, 1929), Vitamin Institute, Stockholm; fundamental biochemical studies.

Switzerland.-Dr. F. Verzar, University of Basel, Basel; environmental stresses and aging.

NOTE. The task of individually assigning proper credit for great medicalscientific discoveries is a difficult and often impossible undertaking. In acknowledging the outstanding work of the individuals afore-mentioned, the committee would feel remiss if it failed to mention mankind's indebtedness to innumerable other individuals, perhaps less well known, who contributed to the continuous unfoldment and refining of discovery which characterizes scientific research.

SIGNIFICANCE OF FOREIGN CONTRIBUTIONS TO PRESENT KNOWLEDGE IN CARDIOVASCULAR MEDICINE

The earliest medical writings show some knowledge of the blood and the importance of the heart as one of the primary organs of the body. An ancient Egyptian papyrus of around 1500 B. C. and Chinese writings of 500 B. C. recorded pulse lore. Aristotle, Hippocrates, and Leonardo da Vinci were among those who studied movements of the heart and the blood system. That heart disease could be chronic was first demonstrated clearly in 1507. But the Greek physician Galen's theory-that the blood ebbed and flowed like the tide-had a strong hold until the 17th century.

BEGINNINGS OF HEART RESEARCH

Heart research really began in 1628 when William Harvey, an English physician working in London, published his findings that the heart pumped the blood continuously in the body. This research made it possible for Harvey's successors to study the heart for what it is-a muscle and a pump. Working painstakingly for over 20 years on animals, Dr. Harvey laid the groundwork for modern physiology and experimental medicine of the 19th century.

The University of Padua in Italy, where Harvey received his first medical degree, also fostered Fabricius, Harvey's teacher, and Andreas Vesalius, a Belgian, who became the founder of modern anatomy in 1543.

Early Clinical Advances.-Clinical discoveries came along slowly, with many set-backs. Bonet of France recognized in 1679 the relationship of shortness of breath to enlargement of the heart, and sudden death associated with calcification of the aorta. At the beginning of the 18th century, the coronary circulation and mitral stenosis and its symptoms were explained by Vieusseus, of France. Lancisi of Italy, physician to Pope Clement XI, described in 1707 cardiac and aortic enlargement and produced the first treatise on sudden death with autopsy findings. Jean Baptiste De Senac, a Frenchman, gave advice about treatment as well as diagnosis, and published in 1749 the first preponderantly clinical work on heart disease. Heberden, in 1768 lectured in England on a disorder of the breast which he called angina pectoris. A few years later Louis Jenner, a London physician, established the connection between angina pectoris and coronary artery disease.

Early Diagnostic Advances.-Tools for studying the heart and circulation were developed gradually.

By inserting a glass tube into the leg of a mare, Stephen Hales, an English clergyman with a scientific mind, first devised a method for measuring the pressure of the blood (1733).