Albert Schweitzer. The man as a symbol

Albert Schweitzer, the great missionary physician from the XXth century, had a versatile personality that integrated multiple talents, leading to the slightly frequent conjunction of the thinker with the man of action, and the humanist with the scientist and the artist. He studied all these disciplines in a brilliant manner: Philosophy, Theology, Music and Medicine; he was also a great scholar of Bach's work, Jesus Christ and the civilization history. In his maturity, this great man renounced to the fame and glory gained as intellectual and musician, to dedicate his life as a physician for the forgotten African natives. His deeply religious spirit allowed him to penetrate into the most recondite of the human soul; in his personality, he expressed in its entire dimension the eternally unsatisfied desire of the solitary man, against the immensity of the universe. His philosophy, based on the respect for life, was realized throughout the practice of the medical profession. His noble character and personality was based on the man as symbol, since it was not so much what he did helping people but what people could do to others due to him. His singular example represented a moral force in the world, superior to millions of men armed for a war. In 1953, he received the Nobel Peace Prize for his philanthropic work in Africa during more that fifty years, and for his deep love to the living beings. He was transformed in a perennial legend as the Lambaréné doctor.     

Climacteric symptom formation: Donovan's contribution

Engaged in evaluating the then newly introduced hormonal therapy of the climacteric syndrome, Donovan, late professor of obstetrics and gynaecology, of Rochester, NY, reached the conclusion that this complex of symptoms was only a clinical artifact. It was, he claimed, the result of the selective attention of doctors when securing medical histories. Though written 30 years ago, Donovan's paper is apparently still provocative enough to be regularly quoted. It has, however, never been closely examined.Looked at in a different light, Donovan's research appears even more interesting. The apparent paradoxes he reports disappear when it is remembered that symptoms are not data but means of communication. His perceptive picture of the influence of doctors on the formation of climacteric symptoms is especially convincing. Much of this is because the main conclusions of this research seem to have come almost as a surprise, forcing themselves on a worker engaged in a restricted field of his speciality. These circumstances probably also account for the reticence shown in drawing more general conclusions from its findings.     

Der Anatom Johann Samuel Eduard d''Alton (1803–1854) — Leben und Wirken in Halle (Saale)

After the death of Johann Friedrich Meckel (1781–1833), Eduard d'Alton was appointed to be his successor. From 1834 to 1854, he was Professor of Anatomy and head of the “Anatomisches Theater” at the University of Halle. In the literature we can only find little details about him. The aim is to investigate his life and work. Before he came to Halle, he was first professor at the Academy of Arts in Berlin. Then few years later he received the professorship of anatomy and physiology at the Friedrich-Wilhelm-University in Berlin. During his work as anatomist and physiologist in Halle he was rector twice, in 1845 and 1846. d'Alton worked very accurately and highly engaged. He supported the students' education very conscientiously but, since he was strict and exacting at the same time, he was not very popular. His extraordinary drawings of human and comparative anatomy earned him great recognition. In 1850, he published the “Handbuch der menschlichen Anatomie”. d'Alton was mainly engaged in comparative anatomy, embryology and teratology and performed experimental embryological tests. In 1853, he published a catalogue of teratological preparations many of which can still be found in the Anatomical Collections in Halle.     

La menespausie--the birth of a syndrome.

The prevalent assumption that climacteric disturbances appeared when the expectation of life of women assured survival past the menopause cannot be supported demographically. These disorders are largely conditioned by sociocultural factors and, therefore, may be expected to have been initiated when these factors became stressful. Historical examination shows that medicine, or its marginal practitioners, were always involved in the postponement of ageing whenever the status of women depended more on their attractiveness than other social determinants, a logical "geriatric" extension of its traditional cosmetic activities. No menopausal disturbances are however recorded until the social convulsions of the French Revolution, and the regimes which followed, seem to have crystalized the various complaints of the climacteric into a disease-expression, which reified the social stress to which women were subject. This is dramatically reflected, both in the medical writings published in France around the year 1800, and in the naming, for the first time, of this phase of woman's life: La Menespausie, soon shortened to Menopause.     

From the "climacteric disease" to the "male climacteric" The historical origins of a modern concept

The historical origins of the modern concept of a "male climacteric" have hitherto been traced to the late 19th and early 20th centuries. Based on a careful scrutiny of early modern and 19th-century sources, this paper shows that the concept goes back much further, however. It evolved from the ancient notion of critical "climacterical years" which recurred every 7th year throughout human life and from the concept of a predominantly male "climacteric disease" which Henry Halford put forward in 1813. In the course of the 19th century, this concept of a "climacteric disease" was gradually reframed under the influence of contemporary interest in the female "menopause" and eventually both largely merged into the single notion of a "climacteric" in both sexes. By 1900, the "climacteric" had become so strongly associated with the female sex that the observation of a "male climacteric" could be presented as a new finding, although the symptoms associated with it were, in retrospect, largely taken from the older notions of the "climacteric disease" and the female "menopause".     

Das wissenschaftliche Programm von Johann Friedrich Meckel d. J. (1781–1833) und seine Bedeutung für die Entwicklung der Wissenschaft vom Leben

Although Johann Friedrich Meckel the Younger was one of the most famous anatomists, his research work has been severely neglected in the recent historiographical literature on the German morphology. The goal of our study is to approach a general characterization of his research program. Our analysis reveals that Meckel introduced the Cuvierian empiricism in Germany, but he also considered the “Abstraktion” as a main component of the scientific knowledge. According to his epistemology on nascent organisms and transmutable species, both, variability and relatedness of the organic forms are important to the same degree. Meckel explicitly adopted the Jean-Baptiste de Lamarcks (1744–1829) evolutionary theories. Even though in Meckel's discourse about diversity the Cuvierian notion of “functional adaptation” was preserved, the main goal of his research program was to demonstrate empirically the “Allgemeinheit des Bildungstypus”. For this purpose, he considered the entire variety of the animal kingdom: normal as well as abnormal organisms, adult specimens and above all embryos. Moreover, he believed that the abnormal development is due to the same laws as the normal development. He applied parallelisms to a new domain, the study of malformation. With Meckel's researches on teratology, a new era in the analyses of the anomalies was opened. They became an integral part of the natural diversity and thus a highly exploited subject of biomedical researches. Meckel's empirical and epistemological writings on the embryology, comparative embryology, teratology, pathology, systematics and comparative anatomy have largely contributed to the foundation of the biological research.     

Johann Friedrich Meckel der Jüngere (1781–1833) — der bedeutende hallesche naturforscher und Gelehrte

Johann Friedrich Meckel the Younger (1781–1833) belongs to the famous scientists of the 19^th century. His research work is enormous. Important termini e.g. diverticulum Meckelii, cartilago Meckelii, Meckel syndrome and Meckel Serres law reflect the scientific results obtained by Meckel. He worked as a professor of anatomy, pathology and zoology at the University of Halle, a town in the Central Germany. Meckel founded the scientific teratology. In the literature he is also refered to the German Curvier. On 8 April 1802, J. F. Meckel defended his doctoral thesis “De cordis conditionibus abnormibus”. On occasion of the 200th anniversary of this event, we like to honor J. F. Meckel the famous German anatomist. Therefore, during the 97^th session of the Anatomische Gesellschaft at Halle, a satellite symposium “From Meckel to genom” was held.     

Ernst haeckel''s ontogenetic recapitulation: irritation and incentive from 1866 to our time

Ernst Haeckel (1834–1919) must count among the most widely known biologists of his time. His monographs on radiolarian skeletons, sponges and medusae immediately became standard works, owing partly to lavish illustrations that later on culminated in his “Art Forms in Nature”, which markedly influenced the “art nouveau” of the early 20th century. Haeckel's main impact, however, came from his numerous popular books that were crucial in transferring Darwin's ideas to continental Europe. Haeckel's main addition was his claim that ontogeny recapitulates phylogeny. It was partly founded on pre-Darwinian observations by J. F. Meckel and K. E. v. Baer who noticed that vertebrate embryos of different species resemble each other more strongly during early ontogenesis than later on. Wishing to illustrate this clearly, Haeckel clandestinely generalized some figures showing early embryos of animals and Man. This “fraud” provided ammunition for his many adversaries, most of whom felt provoked by his antireligious campaigns. The resulting controversies continued well into the 20th century but then subsided. Quite recently, however, they have flared up again, perhaps in connection with progress in molecular embryology that revealed an amazing evolutionary conservation of genes and their cooperation in signal transduction chains. The scientific publications that triggered this flare, and a selection of “Letters to the Editor” in both international science magazines and the German popular press, serve here to show that Haeckel's idea of recapitulation, while having proven its heuristic value, is still causing considerable irritation. This results from the widespread intuition that the marvels of ontogenesis and other biological phenomena must reflect some “intelligent design” rather than Darwinian evolution.     

Pol André Bouin, MD (1870-1962). Bouin's fixative and other contributions to medicine.

Pol André Bouin was a distinguished French scientist who gained international reputation at the turn of the century for his work in histology and reproductive endocrinology. His name has been retained eponymously in the fixative he described in 1897, today known as "Bouin's fixative." The fixative that bears his name is only one of many contributions he made to academic medicine.     

J. Marion Sims,MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review

This review provides a fresh perspective on the work of J. Marion Sims, an Antebellum era physician who invented the vaginally speculum that bears his name. His accent to become the “Father of Modern Gynecology” was his groundbreaking development of the surgical techniques for the repair for vesicovaginal fistula.Recent scholarship, however, has pointed to the dark side of Sims in that his techniques were perfected through his use of Black slave women as his research subjects. In addition, he has been criticized for his failure to use anesthesia during his research operations.This article argues that Sims's work needs to be understood in a broader historical context and within the broader framework of other forms of human experimentation that took place in the nineteenth and twentieth centuries. There is a strong argument that recent attempts to remove Sims from history also have the unintended consequence of removing the contributions of not only the Black slave women who were his subjects in the development of modern obstetrical medicine, but the important role Blacks played in the development of other medical procedures.     

Jacob B. Winslow (1669-1760)

Jacob Winslow was a Dutch born, French naturalized anatomist and physician whose contributions to medicine are abundant. His importance to medicine is undisputed. His personal life included a religious crisis that resulted in his estrangement from his family, but afforded him patrons in Paris to continue his work. Following this conversion, he changed his name to that of his catechist and was rechristened Jacques Benigne Wilson. His respect as an expert was well deserved, and he held several prominent positions during his career in Paris. His main work, Exposition anatomique de la structure du corps humain, was published in 1732 and is considered the first purely anatomical treatise. This review highlights his contributions to anatomy and medicine through the course of his career.     

Attitudes towards the menopause and hormone therapy over the turn of the century

Objective

To assess attitudes and beliefs about the menopausal transition in a population of peri- and postmenopausal women, and if these attitudes differed before and after publication of studies on risks and benefits with hormone therapy (HT).

Materials and methods

In 1999 and 2003 all women aged 53 and 54 years in the community of Linköping, Sweden, were sent a questionnaire about use of HT, menopausal status and attitudes regarding menopause and HT.

Results

Most women regarded menopause as a natural process characterized by both hormonal deficiency and aging and these views did not differ between 1999 and 2003. A majority of women thought that significant climacteric symptoms were a good reason to use HT, but not that women without symptoms should use HT. The fraction of women who supported HT use was, however, significantly lower in 2003 than in 1999. Most women agreed that menopause leads to increased freedom and that it is a relief not to have to think about contraception and pregnancies.

Conclusions

Most Swedish women had a mainly biological view on menopause but nevertheless they thought that only women with climacteric symptoms should use HT. Women's attitudes towards HT have changed after recent reports on risks from long-term use of HT whereas the attitudes towards the menopausal transition were stable. Other factors than attitudes towards menopause affect women's actual use of HT. Probably women's and health care provider's apprehension of the risk-benefit balance of HT use is one such factor.     

Translational mini-review series on vaccines: The Edward Jenner Museum and the history of vaccination

Edward Jenner's discovery of vaccination must rank as one of the most important medical advances of all time and is a prominent example of the power of rational enquiry being brought to bear during the Age of Enlightenment in 18th century Europe. In the modern era many millions of lives are saved each year by vaccines that work essentially on the same principles that were established by Edward Jenner more than 200 years ago. His country home in Berkeley, Gloucestershire, is where he carried out his work and where he spent most of his life. The building is now a museum in which the life and times of Jenner are commemorated including not only the discovery of smallpox vaccination but also his other important scientific contributions to natural history and medicine. The trustees of the Edward Jenner museum are committed to promoting the museum as a real and "virtual" educational centre that is both entertaining and informative.     

Cardiorespiratory control: an Integrated view H.-P. Koepchen in memoriam

SUMMARY  H.-P. Koepchen's presence at this symposium on cardiocirculatory function during sleep would have given us an inspiring impetus. His death has meant a severe loss for all of us. Koepchen's integrated view on cardiorespiratory control and rhythmicity has been the content of his late work. His considerations as documented in various papers are used for this contribution. They are based on earlier experimental studies of spontaneous coordinations of rhythmic activities in anaesthetized dogs, conscious men, and microelectrode recordings and local cooling experiments in the brain stem of anaesthetized dogs and cats, which he had worked on together with his students.     

Climacteric and menopause in seven south-east Asian countries

The menopause is universal, but what about the climacteric? In an attempt to answer this question, a study was conducted in seven south-east Asian countries, namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and Taiwan. Samples of approximately 400 women in each country were questioned about a number of climacteric complaints, incontinence and dyspareunia, consultation of a physician, menopausal status and several background characteristics. Special care was taken to overcome linguistic and cultural problems, and the data collected were kept as objective as possible. From the results obtained we were able to show that the climacteric was indeed experienced in south-east Asian countries, although in a mild form. The prevalence of hot flushes and of sweating was lower than in western countries, but was nevertheless not negligible. The percentages of women who reported the more psychological types of complaint were similar to those in western countries. The occurrence of climacteric complaints affected perceived health status. A physician was consulted for climacteric complaints by 20% of the respondents, although this was most frequently associated with the occurrence of psychological complaints and less so with that of hot flushes and sweating. The median age at menopause (51.09) appeared to be within the ranges observed in western countries. Ethnic background and age at menarche were found to have a significant influence on age at menopause. The study clearly demonstrated that climacteric complaints occur in south-east Asia. The findings suggest, however, that vasomotor-complaint-related distress might be ‘translated’ into psychological complaints, which are more frequently considered to warrant consulting a physician.     

Donald L. Morton Memorial Lecture: the legacy of Donald Morton: past,present and future

Donald L. Morton, MD persevered against great odds throughout his life and career. Beginning in the humblest of circumstances, he worked his way to the highest echelon of academic surgery, revolutionized surgical treatment of melanoma with innovations that rippled through the rest of oncology. His research led to dramatically improved disease staging while also decreasing morbidity. He stood as a champion of immunotherapy for many years when few others believed it would ever work. His greatest professional legacy, and the achievement of which he was most proud, is in the accomplishments of those he trained over his many years in the field.

     

Dr. Gustav Wilhelm Münter (1804–1870) - der unbekannte“ Aufseher der Meckelschen Sammlungen

For 48 years of his life, Dr. Gustav Wilhelm Münter was a diligent, skillful, reliable and indispensable assistant of the Meckel Collections. He was a loyal worker under famous superiors as Johann Friedrich Meckel the Younger (1781–1833), Eduard d'Alton (1803–1854) and Alfred Wilhelm Volkmann (1801–1877). Münter's aim was to get scientific acknowledgement and the position of a Prosector“. But he reached none of it. However, A. W. Volkmann, who often criticized Münter's work, was obligated to say: “It is true, that a very large part of the Meckel Collections had been prepared and put up by him.” Today the Anatomical Collections of Halle include a large number of very nice preparations produced by Münter.     

The history of the male menopause 1848-1936

The explicit intention of the majority of nineteenth and early twentieth century writers on the change of life was to dispel the aura of anxiety they believed surrounded the popular view of the menopause and to encourage middle-aged women (and their husbands) to regard the menopause as a necessary yet transitory phase through which the majority would pass to a higher and more fulfilling stage of life. These writers sometimes include references to the parallel problems of men, and from the latter part of the nineteenth century a distinct form of literature appears in Britain and the U.S.A. which portrays the male climacteric (or 'menopause') in a similar optimistic light. A central feature of this optimism is the gradual eroticisation of everyday life.