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David Bayford. His syndrome and sign of dysphagia lusoria.

David Bayford (1739--90) was an unobtrusive medical worthy of the age of William and John Hunter, with each of whom there are documented links. From 1761, when he obtained the Membership of the Company of Surgeons, to 1782 he practised as a surgeon in London, though he was defeated by John Hunter in his bid for election to the staff of St George's Hospital in 1768. In 1782 he proceeded to the MD, granted by the Archbishop of Canterbury, when he removed to Lewes in East Sussex, where he practised as a physician. He later became disfranchised by the Company of Surgeons in order to obtain the Licentiate of the College of Physicians. In 1761, while still an apprentice surgeon, he made his discovery of the unique and bizarre cause--compression of the oesophagus by an aberrant right subclavian artery--of a fatal case of 'obstructed deglutition' for which he coined the term 'dysphagia lusoria' and for which he is eponymously remembered. This discovery remained unrecorded until 1787, when a paper describing the case was read on his behalf before the Medical Society of London.

Deglutition Disorders↗

[Netherton-Comel's syndrome].

Two cases of the so-called Netherton's syndrome are described and the relevant literature is reviewed. On the author's opinion there exists no relationship between the disease and ichthyosiform dermatoses. It fits more adequately in the group of the "Génodermatoses érythémato-desquamatives circinées variables" of Bazex and Dupré. The syndrome is characterized by the association of two tipical clinical features: "Trichorrhexis invaginata", reported by Netherton and the "Ichthyosis linearis circumflexa", described by Comel. The authors propose therefore the eponymous designation of "Syndrome of Netherton-Comel". As there exists no link with the group of the ichthyosiform dermatoses, the authors suggest the name of "Dyskeratosis figurata variabilis" for the disease described described by Comel.

Adolescent↗

Eisenmenger's syndrome and pregnancy.

The Eisenmenger's syndrome (E.S.) was redefined by Wood (1958) as pulmonary hypertension with reversed or bidirectional shunt at the aortopulmonary, ventricular or atrial level. This eponym is applicable to 12 different congenital cardiac lesions. Pregnancy in patients with E.S. is a particularly hazardous situation in respect to the prohibitive features of maternal and perinatal mortality (Gleicher et al., 1979; Jones & Howitt, 1965; Neilson et al., 1971).

Adult↗

Charles Lasègue and his 'Considerations on Sciatica'.

The eponym Lasègue sign has been applied to the increase in sciatic pain caused by flexing the extended lower extremity on the abdomen. The sign was never put into writing by Lasègue but by his pupils. He did not describe the test in the usual reference, "Considerations on Sciatica," in 1864. That article has to do with his analysis of then-current theories of sciatica and his own clinical observations. Sciatica was divided into a benign and a serious form, and two examples of each were described. Emphasis was laid on the constant, fixed sciatic pain, as contrasted with the irregular, largely nocturnal, episodes of lancinating pain. Atrophy of leg muscles was not to be explained on the basis of disuse but by a disorder of the nerve, which also was responsible for the typical neuralgia, unlike that of any other part of the body except possibly neuralgia of the brachial plexus. Treatments currently available (cupping, vesicants, and injections of atropine solution) were unavailing. The steps are unknown by which Lasègue came to modify his 1864 views that any sort of flexion or extension of the lower extremity did not exacerbate the pain; in the 1881 thesis of his pupil, Forst, that straight-leg raising sign is described and illustrated and ascribed to his teacher, Professor Lasègue.

France↗

Early Dutch contributions on Peyronie's disease.

Long before De la Peyronie's description of three cases of plastic induration and curvature of the penis (1743) the disorder was already known. The Ephemerides (1687) and the rather scabrous booklet, Venus minzieke gasthuis (Venus Hospital for the lovesick)(1688), contain short remarks on this condition. Two extensive Dutch contributions -- not mentioned in the literature on this subject -- were written by Nicolaas Tulp (1593--1674) and Fredrik Ruysch (1638--1731). The first one is a case history, the second one is more general discussion with a fine engraving added. Treatment varied according to the various early authors. The therapeutic successes claimed must be seen in the light of the natural history of this disease: spontaneous improvement occurs not infrequently. To change the eponym 'Peyronie's disease', however, seems unjustified. It is an homage to François Gigot de la Peyronie (1678-1747) surgeon to King Louis XV and founder of the French Académie de Chirurgie.

France↗

Schilder's myelinoclastic diffuse sclerosis.

The term "Schilder's disease" has been used to describe conditions as disparate as adrenoleukodystrophy, myelinoclastic diffuse sclerosis, and postinfectious and postvaccinal encephalomyelitis. The eponymic designation should be reserved for instances of myelinoclastic diffuse sclerosis that correspond to the case described by Schilder in 1912. The diagnosis cannot be made unless adrenoleukodystrophy has been ruled out by analysis of the long-chain fatty acids of plasma cholesterol esters. Schilder's myelinoclastic diffuse sclerosis, a variant of multiple sclerosis, is a very rare disease that occurs in children and adults of both sexes and appears to respond to vigorous treatment with corticosteroids and/or corticotropin. A case of this disease is reported and the recent literature of cases that have been called Schilder's disease is reviewed.

Adrenoleukodystrophy↗

So-called 'acute retinal necrosis syndrome'--an acute ocular panvasculitis syndrome.

An acute ocular disorder, characterized by panuveitis, retinal vasculitis, retinal necrosis (with frequent secondary retinal detachment) and frequent optic atrophy, has been reported since 1971 under different eponyms in 74 patients (103 eyes). I report 4 more cases. This paper presents, based on a critical review of 107 eyes in 78 patients, a detailed clinical description, pathogenesis and terminology of this distinct ocular disease entity. The available clinical and histopathological evidence very strongly indicates that the basic pathology is acute vasculitis of the iris, choroid, retina and optic nerve head, producing vascular occlusion in the choroid, retina and optic nerve head; the clinical findings thus represent acute ischemic lesions of those tissues, in addition to panuveitis. From the available evidence, it seems more appropriate to call this condition 'acute ocular panvasculitis syndrome' rather than 'acute retinal necrosis syndrome' since retinal necrosis is only one of a number of lesions seen in this disease. The etiology of the panvasculitis still remains a mystery.

Acute Disease↗

Sequelae of stomach surgery.

Gastric surgery has undergone continuous evolution since the 19th century. At present it is a highly sophisticated technique which provides symptomatic relief for the vast majority of patients operated upon for peptic ulcer disease. Although the overall incidence of complications has decreased, a variety of complications continues to occur and radiological examination plays a critical role in their detection, evaluation, and management. Knowledge of the variations in surgical terminology and commonly used eponyms provides the basic framework for discussion. Familiarity with the radiological appearance of the normal postoperative stomach together with an understanding of its physiology are essential prerequisites to the recognition of possible complications. Operative techniques may result in a radiographic appearance which simulates disease. Conditions as diverse as bezoars, afferent and efferent loop problems, marginal ulceration, anastomotic leakage, prolapse, and intussuception may all be characterized by distinct and highly specific radiographic changes. Physiologic problems such as dumping and malabsorption may also reflect their presence by X-ray changes. The radiographic features in a large number of surgical complications are discussed and illustrated. The importance of the radiographic examination in the postsurgical stomach is emphasized.

Digestive System↗

Demythologizing oedipus.

The oedipus complex is a basic psychoanalytic concept, which is only historically tied to its eponymic myth. It works in our system and in our method as a hermeneutic principle, organizing our understanding of the discourse of patients. Its validity depends on the situation of childhood development within the family, with its attendant passions and desires.

Child↗

Fractures of the distal end of the radius. An historical account.

From the time of Hippocrates to the beginning of the nineteenth century, fractures of the distal end of the radius were mistaken for dislocations of the wrist. Clinical observations, anatomic dissections, and experiments on cadavers dispelled this error. It was not, however, until after the discovery of roentgenograms that the variety and complexity of these common injuries could be appreciated. From the large group of fractures of the distal end of the radius, three distinct varieties can be distinguished rather easily, and to them the eponyms of Colles (Pouteau-Colles), Smith, and Barton have been applied. The remainder, which consist of a substantial number, do not fit into any specific category and must be described individually.

Colles' Fracture↗

[Johann Friedrich Meckel, Jr. as founder of scientific teratology].

n the occasion of the 150th anniversary of his death, the scientific work of the famous German anatomist Johann Friedrich Meckel (1781 to 1833) in Halle is appreciated. The Younger Meckel is counted to the most outstanding figures in the history of anatomy and medicine in the first third of 19th century. According to his founded knowledges in the normal, comparative, and pathologic anatomy and embryology he was able to give a scientific argument of malformations first of all in the history of medicine and biology. The edition of Meckel's Handbook of Pathologic Anatomy (in German language; 1st vol. 1812) is the birth of scientific teratology. Through his contributions to teratology Meckel directly participated in the raising of general pathology and pathologic anatomy to scientific disciplines. Meckel's interceding for C. F. Wolff's theory of epigenesis, not at last by translation of Wolff's paper "De formatione intestinorum" (1768 to 1769) into the German language, accelerated the development of the general and special embryology during the 19th century. In the contemporary medicine the succeeding eponyms are reminding of the imposing German physician and anatomist: the Meckel's diverticulum of ileum (1809), the Meckel's cartilage of the mandibular arch (1820) and the so-called Meckel syndrome (1822).

Abnormalities, Severe Teratoid↗

[History of the discovery of the Lasègue phenomenon and its variants].

Ernest Charles Lasègue (1816-1883) discovered, but did not describe himself, the straight-leg-raising sign. This sign was described by one of this disciples, J.-J. Forst, in a doctoral thesis in Paris in 1881. Almost at the same time, L.K. Lazarević in Belgrade dealt with the same subject. The crossed-sciatic phenomenon was described for the first time by a Polish neurologist, J. Fajersztajn. In the same publication he mentioned the possibility of the activation of sciatica as a result of dorsiflexion of the foot. Independently of Fajersztajn, the Genevan specialist for internal medicine, Maurice Roch, observed the same phenomenon and called it "Lasègue du pied". The eponym "Bragard sign" for this manoeuvre is not correct.

History, 19th Century↗

Sarcoidosis.

Sarcoidosis is a disease of unknown etiology with protean manifestations. Its history is revealed in its many eponymic syndromes. The histologic features are nonspecific, as are most of the clinical manifestations. The diagnosis is made by exclusion. The immunologic abnormalities are fascinating, with features of both hyperactivity and depression. Therapy is nonspecific and generally symptomatic.

Bone Cysts↗

Pott's disease before Pott.

Pott's disease, i.e. caries of the spine with gibbosity, psoas abscesses and palsy, has been known since antiquity, its relation with tuberculosis suspected, as is seen in the Hippocratic writings. In the 18th century cases were studied in France and England; in the Netherlands by Hovius, Camper, Bonn and Coopmans. The most lucid descriptions however were those of SIR PERCIVALL POTT (1779). An annotated Dutch translation by DU PUI (1779) called attention to the treatment of this disease which was on the increase. In retrospect the eponym 'Pott's disease' seems well deserved.

History, 16th Century↗

Nonarticular osteochondroses.

Nonarticular osteochondroses represent disordered enchondral ossification of epiphysis or apophysis at specific sites of muscle/tendon insertions or ligament attachments. Traditionally, osteochondroses have been identified by eponymic proper names. A generic classification is based upon the relationship of excessive or repetitive traction in occasional combination with direct pressure at discrete anatomical sites. The following are models of the several varieties: Osgood-Schlatter syndrome, typifying muscle/tendon stress on the tibial tuberosity; medial epicondylosis (Adams), resulting from forearm and elbow stress generated by muscles and creating traction through the ulnar collateral ligament attachment; and Sever's syndrome (calcaneal apophysis), associated with tension at either end of the calcaneal apophysis in combination with direct impact pressure. The general characteristics of this group include symptoms of pain or tenderness, timed appearance coincident with the developmental sequence of the apophysis, and generally symptomatic management.

Adolescent↗

[Sudden death in children and adolescents, carriers of an unrecognized cystic medionecrosis of the aorta].

Four instances of sudden death in childhood and adolescence with autopsy findings are presented. In the four cases unsuspected cystic medionecrosis of the aorta was discovered. In three of the four patients it was associated with a cardiovascular malformation, viz (1) double coarctation of the aorta, (2) coarctation of the aorta associated with Ebstein anomaly, and (3) subvalvular aortic stenosis. In three patients ocular abnormalities were demonstrated as an additional autopsy finding. Only one child could be said to have the Marfan habitus. We suggest that until new biological criteria emerge such observations should remain classified under the eponym of Marfan syndrome.

Adolescent↗

Staging of carcinoma of the colon and rectum.

Commonly used modifications of the Dukes' system for staging carcinomas of the colon and rectum are inaccurately presented in many current textbooks and articles. These modifications divide Dukes' Stage B category into B1 and B2, depending upon whether or not the lesion has invaded or penetrated the muscularis propria. The term muscularis propria has been incorrectly interpreted to mean muscularis mucosa; as a result, A, B1 and B2 lesions, according to the modified systems all correspond to Dukes' Stage A category, and there is no modified stage corresponding to Dukes' Stage B. It is suggested that the term "modified Dukes" be discarded and that modified systems be given the eponyms of their describers. If the modified systems are to be continued, they must be correctly understood and presented. The simple and unambiguous nature of the original Dukes' system, however, favors its widespread use.

Carcinoma↗

Extraskeletal Ewing's sarcoma: prolonged survival with recurrence after operation.

Unlike the osseous variety, extraskeletal small cell tumors histologically identical to Ewing's sarcoma of bone frequently respond to radical surgical excision. The relative infrequence of this tumor, compounded by the comprehensive eponym "Ewing's sarcoma," may deter surgical intervention in this group of patients. This patient's course demonstrates the value of surgery alone, but emphasizes the role of combined surgery, irradiation, and chemotherapy as the best management for extraskeletal Ewing's sarcoma.

Adult↗