Richard Caton (1842-1926): pioneer electrophysiologist and cardiologist

Richard Caton is recognized as the discoverer of the waves of electrical potential which today form the basis of electroencephalography. He reported his finding in three communications, two in the British Medical Journal and one to the Ninth International Congress of Medicine at Washington, DC. After defending his priority in having made this discovery, he did no further work on the brain: his family and colleagues were unaware of his discovery for many years after his death. This was possible partly because of many other things that he did in his long life but also because, in his later years, he took deliberate steps to hide the fact that he had worked on the brain. The most important of these other activities was a practical study of the treatment of rheumatic heart disease. The basis of his treatment--complete rest in bed--is still in use today.     

Thomas Cecil Gray CBE (1913-2008) An outstanding Editor of the British Journal of Anaesthesia (1948-1964)

Thomas Cecil Gray was born in Liverpool in 1913, and was educatedat Ampleforth College and Liverpool University where he graduatedin medicine in 1937. Becoming interested in anaesthetics whena general practitioner in Liverpool, he was trained by R.J.Minnitt who was, and continued to be for many years, a memberof the British Journal of Anaesthesia (BJA) Board. After warservice in North Africa, where he was attached to a neurosurgicalunit, Gray was invalided out in 1944. He later resumed a demandingcivilian anaesthetic and general practice. It was at this timethat he began investigating the ways in which tubocurarine mightbe used as an adjunct to general anaesthesia, as others werefollowing the report by Griffith and Johnson in Anesthesiology     

Follow-Up Study of the Use of Refrigerated Homogenous Bone Transplants in Orthopaedic Operations

Philip Duncan Wilson was born in Columbus, Ohio. His father was a family physician who held the Chair of Obstetrics in the Sterling Medical School [1]. The young Philip graduated from Harvard College in 1909 and then served as President of his graduating class at Harvard Medical School. He spent two years as a surgical intern at MGH, after which he returned to Columbus to practice. During WWI he was invited back to Boston to join the Harvard Unit under Harvey Cushing, and served with that unit when it was housed in the Lycée Pasteur. (The members of that unit included Marius Smith-Petersen, who also spent many years at the Massachusetts General Hospital and also became AAOS President.) He rejoined MGH on the staff in 1919. In 1925 he published an influential monograph with W.A. Cochrane (formerly of the Edinburgh Royal Infirmary), entitled, “Fractures and Dislocations” [5]. Toward the end of his years in Boston he helped found the American Academy of Orthopaedic Surgeons. In 1934 he was appointed as Surgeon-in-Chief at the Hospital for the Ruptured and Crippled in New York City. Dr. Wilson was active in many organizations, and reorganized and renamed the hospital he served (Hospital for Special Surgery), oversaw the building of a new hospital at its current site on the Cornell University medical campus, and raised money for a large research building. His zest inspired generations, and he was known for his gracious hospitality. Dr. Wilson was one of three of the first fifteen Presidents (the others being Drs. John C. Wilson, Sr. and Melvin Henderson) whose son (Dr. Philip D. Wilson, Jr.) succeeded him as a President of the American Academy of Orthopaedic Surgeons. Dr. Wilson had a long interest in bone grafting and wrote numerous research papers, a few of which are referenced here [2–4]. In the article reprinted in this issue [3], he described the rapid increase in use of a bone bank he developed at the Hospital for Special Surgery in 1946: 19 operations using grafts in 1946, 48 in 1947, 106 in 1948, 134 in 1949, and 259 in 1950. He describes his animal experiments with autogenous grafts in which grafts rapidly incorporated. He further describes biopsies of previously implanted autogenous and homogenous bone transplants in patients undergoing serial fusions for scoliosis. The pathologist (Dr. Milton Helpern) commented they found “...no evidence that the cells in the bone transplants survived...” Autogenous grafts, his evidence suggested, incorporated more rapidly that homogenous grafts, but “...in the end the results are the same.” His followup studies suggested successful incorporation of graft in 210 of 248 cases.

Long-term remission of nephrotic syndrome with etanercept for concomitant juvenile idiopathic arthritis

Etanercept is a tumor necrosis factor (TNF)-α inhibitor that has been applied beneficially for juvenile idiopathic arthritis (JIA). We experienced long-term remission of nephrotic syndrome (NS) in a boy treated with etanercept, which was initially used for concomitant JIA. He developed NS at age 3 years 7 months and had mostly been treated with cyclosporine because of steroid dependency and frequent relapses. Cyclosporine was halted at 10 years 7 months because of nephrotoxicity, and he was subsequently treated with mizoribine. However, he had three relapses in the first year and developed JIA at 11 years 7 months. He was treated with sulfasalazine, methotrexate, and prednisolone, but his arthritis persisted. Etanercept was started at 12 years 3 months. Thereafter, his arthritis went into complete remission. Surprisingly, he has remained relapse-free for both NS and JIA for more than 3 years with etanercept and mizoribine. It is difficult to know whether the NS remission after initiating etanercept was coincidental. However, there are many reports of increased TNF-α or soluble TNF-α receptor in NS relapse. To date, there are two reports of the efficacy of TNF-α inhibitors against NS. It is possible that TNF-α inhibitors may have potential as therapeutic agents for NS.     

Joseph H. Boyes, MD, 1905-1995: a driving force in American hand surgery

Joseph H. Boyes, MD (1905-1995) was an important figure in American Hand Surgery. He was a pivotal founder of the American Society for Surgery of the Hand (ASSH), he trained a number of hand fellows, he was active for many years at national and international hand meetings, and he was the founding editor of the Journal of Hand Surgery.     

The life and time of Guillaume Dupuytren

Guillaume Dupuytren's good fortune was the time of his birth. He was a product of revolutionary change in France, and without it he would never have become a surgeon. From south central France he came to Paris to become a surgeon and reached his goal, literally, "on a crust of bread". Dupuytren is remembered principally for the hand condition which bears his name; his other numerous and more-important contributions have been ignored. Never happy outside the operating room--or perhaps inside it either, due to his mania for perfection--this arrogant master surgeon constantly clashed with his colleagues, staff and the few friends he had. When he died at the age of 57 years, he had advanced surgery on many frontiers.     

Further remembrances of that revered anatomist, Dr. J. C. Boileau Grant

From access to a detailed curriculum vitae written by Dr. Grant when he was about 75 years old, the author has learned some little-known facts of his background and life. His ancestors came from France and had been ennobled. One predecessor was a mayor of Paris. Several of his family decided to emigrate to Great Britain with the Huguenot movement. Grant graduated from the University of Edinburgh in 1908 in the same class as his future brother-in-law, William Boyd. When World War I was declared, he immediately volunteered for the army. During service on the Western Front, he was mentioned in dispatches in 1916, won the Military Cross in 1917 and a bar to the Military Cross in 1918. At the outbreak of World War II, Grant, who had been a professor of anatomy first in Winnipeg and then in Toronto for many years, volunteered again for war service, but was rejected as being too valuable a teacher to be allowed to enlist.     

Medical politician and man of Olympian vision and energy: Dr William Penny Brookes (1809-95) of Much Wenlock

William Penny Brookes lived all his life in Much Wenlock in Shropshire where he worked as a general practitioner for 60 years. He is now best remembered as the founder of the Wenlock Olympian Society, as a founding member of the first national Olympian association and for his influence on Baron Pierre de Coubertin, the founder of the modern Olympic movement. He was a tireless campaigner for the introduction of physical education and a lessening of the academic workload in elementary schools. He was also an important figure?in the medical reform movement of the mid-19th century. In Much Wenlock he was a much respected philanthropist and was involved in many civic activities. He was also a notable botanist and antiquarian.     

Arthur Keith, the anatomist who envisioned herniosis

Arthur Keith (1866–1955) was a renowned anatomist who published 529 contributions emphasizing the interaction between structure, function, and patient care. His only practice was 4 years as a family doctor, although he later trained to be a surgeon. Ten of his many articles related to hernia; two (1906, 1924) dealt with etiology. In these he rejected Russell’s congenital saccular theory of abdominal herniation, since the latter’s assertions regarding peritoneal diverticula were not supported by embryological research. Instead, Keith became the first to hypothesize that defects in the belly wall of adults were brought about by pathological damage to fasciae, aponeuroses and tendons, secondary to systemic connective tissue disease abetted by aging. The pelvis was similarly afflicted, leading to vaginal prolapse, the most common hernia among women. Diverticula were likely to sprout from a weakened alimentary tract. He stated that prevention was a serious consideration. The surgical establishment, overburdened by dogmas accumulated from 5,000 years of being solely responsible for the care of patients with herniae, ignored his hypothesis for decades. However, recent research in herniology has made him a prophet.     

How David Hatch became a professor of pediatric anesthesia

This is an account of an interview with David John Hatch who was one of the first Professors of Pediatric Anesthesia in the world. He began his anesthesia career as a medical student administering chloroform and ended it 40 years later as a Consultant at Great Ormond Street Hospital where he developed and led a world renowned research team measuring and assessing lung function in infants and children. These productive years earned him his chair at the Institute of Child Health in London (part of University College London) funded by Portex (currently, a branch of Smiths Medical). His academic achievements include over 110 journal publications, two textbooks and having many honors and awards. Yet he does not think of himself as an academic. In his words “I wanted to be a hard working clinician with an interest in research, and not just academic”.     

William Gregory (1803-58): Professor of Chemistry at the University of Edinburgh and enthusiast for phrenology and mesmerism

William Gregory was descended from a long line of academics. Although he graduated in medicine, he had earlier determined on a career in Chemistry but more particularly to succeed Professor Thomas Charles Hope in the Edinburgh Chair in that discipline. At various times during the 1830s and 1840s he studied Chemistry at Giessen in Germany under Professor Justus Liebig and was closely associated with him over the succeeding years, translating and editing in all seven of his books. Gregory taught initially in London, at the Edinburgh Extra-mural School, in Dublin, at the Andersonian University, Glasgow and as Mediciner and Professor of Chemistry in Aberdeen. In 1844 he was appointed to the Chair of Chemistry in Edinburgh and remained in this post until his death in 1858. Shortly after he graduated he joined the Edinburgh Phrenological Society (he was initially its Secretary and later President) and took a particularly active role in the meetings of this Society and in the Aberdeen Phrenological Society. He was also interested in the phenomena of Mesmerism and Mesmero-Phrenology, despite the agitation and scorn of many of his academic colleagues both in Aberdeen and in Edinburgh.     

Elbow and Shoulder Lesions of Baseball Players*

George Eli Bennett was born in Claryville, NY, in the Catskill Mountains, in 1885 [3]. His parents both died by the time he was 11, leaving him the need to work while going to school, but he excelled in school and sports. He played semipro baseball at the age of 16. After high school he work in various jobs in the Midwest before he could afford to attend the University of Maryland Medical School, from which he graduated in 1908. At the age of 25 in 1910, he joined the staff at the Johns Hopkins Hospital, where he remained until his resignation in 1947. Dr. Bennett was one of a few men who served as President of both the American Orthopaedic Association and the American Academy of Orthopaedic Surgeons. While Dr. Bennett made many contributions to orthopaedic surgery, including children’s and nonoperative orthopaedics, he was best known for his work in sports medicine (undoubtedly related to his being a gifted athlete). His fame extended well beyond the orthopaedic community, for he treated many famous athletes. Sports Illustrated recognized him upon his death in an article entitled, “Mender of Immortals” [4]. His intimate knowledge of sports undoubtedly contributed to his sage judgments. At an emotional dinner in 1958 many famous athletes sometimes tearfully paid tribute to Dr. Bennett. Joe Garagiola commented on the occasion, “After listening to that all-star team of players Dr. Bennett has mended, I’m sorry I didn’t break my leg” [4].     

Robert Robertson, FRS (1742-1829): physician to the Royal Hospital, Greenwich, 18th-century authority on 'fever', and early practitioner in care of the elderly

Robert Robertson was born in Scotland and trained to be a surgeon. In 1760, he served briefly on a whaling ship and then entered the Royal Navy. He subsequently had many postings, several of them to the tropics. He recorded his observations on fevers, scurvy and other illnesses. After 23 years of active service, he retired to private practice in Hampshire. However, later he rejoined the service and was appointed physician to the Royal Hospital, Greenwich, where later he was made a Director. During this period, he addressed the problems of illness after the days of active service. Robertson was thus an early practitioner in the care of the elderly. He retired in 1807 and died at Greenwich at the age of 87.     

Lacunar infarction in brain tumor patients: chronic stage complication after radiation therapy

The authors reported two relatively young adults with lacunar infarction that took place many years after radiation therapy. The first case was that of a 41-year-old male presenting with a slight decrease in consciousness and right hemiparesis of sudden occurrence. MRI revealed a lacunar infarction in the left internal capsule. This patient had received radiation therapy and chemotherapy for a right basal ganglia germinoma when he was 24 years old. The tumor completely disappeared and he was able to return to work. The second case was a 24-year-old female presenting with dysesthesia in the right upper extremity and nausea of sudden occurrence. MRI disclosed a lacunar infarct in the right corona radiata. The patient had received radiation therapy for a suprasellar tumor when she was 11 years old. The tumor considerably decreased in size and the patient conducted normal social life thereafter. MRI showed a lacunar infarction in the right corona radiata. Review of the literature was made and the possibility of radiation therapy as a causative factor of the lacunar infarction in relatively young adults was discussed.     

Hans-Lukas Teuber: A Tribute

Hans-Lukas Teuber (1916–1977) was one of the most influentialneuropsychologists of his generation. In the first part of hiscareer he headed the Psychophysiology Laboratory at the NewYork University - Bellevue Medical Center. There he and hisassociates played a major role in establishing human neuropsychologyas a rigorous experimental science closely linked to contemporaryneurophysiology and experimental psychology. In the second partof his career he founded the Department of Psychology at theMassachusetts Institute of Technology. This rapidly became aworld center of the neuro- and cognitive sciences and a modelfor the establishment of new neuroscience centers that broughttogether neuroanatomy, neurophysiology, neuropsychology, andcognitive psychology into an interacting community. Teuber‘s contributions extended far beyond the institutionshe founded and the many important experimental and theoreticalpapers he wrote. He was a consummate organizer, synthesizer,and sponsor of research on the brain, as well as the mentorof many of today’s leading brain researchers. This specialissue on object recognition and the temporal lobes is dedicatedto his memory.     

Forgotten nephrologists: Leonhard Thurneysser and Hermann Senator

Leonhard Thurneysser and Hermann Senator are examples of "Forgotten Nephrologists". Leonhard Thurneysser was born in Basel, Switzerland in the 16th Century and worked for many years in Berlin. He was a goldsmith, miner, printer, astrologist and uroscopist. He traveled all over Europe. His importance stems from the physicochemical methods he introduced into uroscopy. He prosposed that urine distillates and their residues should be burnt in order to define their composition from the colour of the flame. He developed a overcomplicated system of fractionated distillations and drew more and more speculative conclusions. Hermann Senator lived in the 19th Century. Born and trained in Berlin, he became a critical and experienced nephrologist. His observations of "physiological" and "pathological" protein excretion in humans became important. Critical oberservations in the hospital, experimental testing of derived hypotheses and careful analyses of derived concepts characterize his work. He stimulated many young physicians to cooperate. Together with Munck he formulated the "Senator-Munck-Doctrine", according to which current concepts of urine formation as postulated by Bowman, Ludwig, Heidenhain et al could be and were unified in a "Filtration-Secretion-Reabsorption-Concept".     

Intracerebral xanthogranuloma with specific MRI features: a case report

We report a case of a 47-year-old male who had a left frontal lobe mass with specific magnetic resonance imaging (MRI). Four years previous to his admission to our hospital, he developed acute myelocytic leukemia and he was implanted with peripheral blood stem cell transplantation. One month before his admission, he was unable to walk due to right leg motor weakness. MRI revealed a round mass lesion at the left frontal lobe. Initial diagnosis was a brain abscess, so he was administered some antibacterial drug. However, his neurological symptoms kept getting worse with increase of mass size on MRI. T1-weighted MR images showed the mass as a low intensity lesion with incomplete ring-like Gd-enhancement. T2-weighted images showed the mass as a high intensity lesion with many linear shadows inside the mass. Diffusion weighted images showed the mass as a low intensity lesion. MR spectroscopy revealed an elevation of choline and lactate peak. Differential diagnosis was glioma or demyelinating disease. At the operation, the mass was light yellow and seen to be rich with vessels. The pathological diagnosis was xanthogranuloma in the brain. Postoperative course was uneventful. The frontal residual mass lesion decreased in size and Gd-enhancement.     

Arthroplasty of the Elbow

Willis Cohoon Campbell was born in Jackson, Mississippi in 1880. He received his undergraduate training in his home state and medical training at the University of Virginia, Charlottesville, where he graduated in 1924 [5]. After serving a two-year internship, he went into private practice in Memphis, Tennessee. As with other prominent orthopaedic surgeons (Ryerson among them), he visited medical centers in Europe, particularly London and Vienna. He evidently then spent some time in postgraduate work in New York City prior to returning to private practice in Memphis. (Most formal residencies were not established until the 1930s coincident with the formation of the American Board of Orthopaedic Surgery in 1934, although many doctors took “postgraduate” work following one or two years of internship in general medicine or surgery.) In 1910, he was asked to organize a Department of Orthopaedic Surgery at the University of Tennessee Medical School as the first Professor of Orthopaedics, a post he held until his death. In addition to forming a department for the university, Campbell helped establish one of the first hospitals for crippled children in the south, then the Willis Cohoon Campbell Clinic in 1920 [1], and finally in 1923 the Hospital for Crippled Adults. The Campbell clinic provided postgraduate training, meeting the requirements of the American Board for the Certification of Specialists. Dr. Campbell, while not one of the original nine board members of the American Board of Orthopaedic Surgery, was influential in establishing the Board in 1934. According to Wickstrom [4], a “...persistent rumor, repeatedly denied, held that Henderson (Melvin) and Campbell were the primary movers behind the establishment of both the American Academy of Orthopaedic surgeons and the American Board in Orthopaedic Surgery; their actions were said to be a retaliatory response to their rejection by the orthopaedic establishment ‘in the East.’” Be that as it may, Dr. Campbell served as President of a number of professional organizations [1]. He published many papers and three monographs, including the classic “Operative Orthopaedics” [3], which has gone through 10 editions, was the standard textbook for orthopaedic surgeons for decades and remains one of the most widely read references. Dr. Campbell was widely known as a kind, courteous man [5].     

Dr George Home: Royal Australasian College of Surgeons Fellow 169

George Home was Fellow number 169 of the Royal Australasian College of Surgeons. He was born in San Francisco in 1870, coming to New Zealand as an infant. He overcame the early death of his father to excel at school and graduate top of his class at the University of Edinburgh in 1892. During his time in Edinburgh, he was taught by Lord Lister and developed a lifelong interest in surgical asepsis and antisepsis. After working in Liverpool for five years, he returned to New Zealand and commenced practice as a surgeon in New Plymouth in 1899. He remained in New Plymouth for the remainder of his life, although served with distinction in World War I and was the longest serving New Zealand medical officer in the Gallipoli Campaign. Upon his return to New Zealand after World War I, he founded and developed many community institutions and was a noted amateur alpinist, photographer and botanist. He died in 1956 after a lifetime dominated, not by one single achievement, but by much service to his community.