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At least 955 records · Page 53Linked to original sources
PubMed1998

Osler's legacies to dermatologists.

A century ago, Dr William Osler was the best-known physician in the world. Although not yet Sir William, an honor bestowed in 1909, his encyclopedic Principles and Practice of Medicine of 1892 had been translated into many languages and was to see several further editions. Meanwhile, his fame as a teacher, speaker, essayist, educational administrator, clinical investigator, medical consultant par excellence, kind and wise mentor and friend, humanist, bibliophile and collector, practical joker, and loving family man had made him a legend when he was barely 40 years old. A native of Canada, who at the age of 35 came to the United States for 21 years and then moved to England for the final 14 years. Osler's stunning list of achievements continued until his death in 1919 and has since become a myth in its magnitude, aided substantially by the 1925 Pulitzer-prize-winning, huge, and adoring biography by his student and acolyte, Harvey Cushing. Today, dermatologists can recite the cutaneous signs of Cushing's disease, but may be less secure in stating (or, more importantly, identifying) a variety of lesions associated with Osler's name. This article reviews those lesions which commemorate the name and dermatologic contributions of this great physician. In addition, other contributions and important personal characteristics that justify keeping his memory alive are discussed.

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PubMed2003

Dupuytren's disease or Cooper's contracture?: Kenneth Fitzpatrick Russell Memorial Lecture.

In his position as curator of the Cowlishaw collection of historical medical books in the Library of the College, Kenneth Russell prepared the definitive catalogue of the collection. This catalogue is comprehensive and for almost all entries there is an annotation that demonstrates his meticulous attention to detail and the love of the book collection that he managed to secure for the College. It is from this catalogue that I have chosen two books in particular that bring together two great surgeons of the turn of the 19th century. Although he was a pupil of the great John Hunter, the young Astley Cooper possessed good manners and a gift of oratory of which the Scot, his teacher, was devoid. After his apprenticeship with Henry Cline senior, Cooper came to share the podium with Cline at Guy's and St Thomas' hospitals and the two dominated surgical teaching in London for some 22 years, until Cline's retirement in 1811. It was the latter who was first to recognize the true nature of the condition now known as Dupuytren's disease. Later, in 1822, Cooper wrote a detailed description of the contracture of the palmar aponeurosis and recommended fasciotomy as being curative. His book A Treatise on Dislocations and Fractures of the Joints, which contains this description of Dupuytren's contracture, is held in the Cowlishaw Collection. On the other side of the English Channel, M. le Baron Dupuytren repeatedly misquoted Cooper and stated that Cooper believed that the disease was incurable. In his famous lecture given to the staff of the Hôtel Dieu in Paris on 5th December 1931, he admitted to having seen 30 or 40 cases over 20 years of practice. It seems likely that he was not aware of the true cause of the condition before 1831 when he treated his first case. This lecture, along with others, are recorded in his Leçons Orales de Clinique Chirurgicale, a copy of which is also to be found in the Cowlishaw Collection.

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PubMed2002

The contribution of J. H. Jackson to present-day epileptology.

Contributions made by John Hughlings Jackson (1835-1911) to today's epileptology are unparalleled, and what he did has still not been reevaluated. We divide his contributions into three themes: (a) He began his research with the seizures later named jacksonian seizures. Through his research, Jackson established a revolutionary definition quite similar to our contemporary definition of epilepsy. The first step was made to the neurosurgical treatment for epilepsy through his research. (b) He elucidated the mechanism of postepileptic psychosis by his theory of evolution-dissolution and positive-negative symptoms, later called jacksonism. (c) His encounter with his patient, Dr. Z, helped him to establish his idea of dreamy state, eventually leading to the concept of temporal lobe epilepsy.

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PubMed2000

Gender differences in diagnosis and treatment of coronary artery disease from 1981 to 1997. No evidence for the Yentl syndrome.

AIMS: The aim of the present clinical study was to evaluate whether gender-related differences existed as regards the extent and localization of coronary artery lesions in patients with angiographically documented coronary artery disease, and whether these angiographic findings would lead to differences in further management. METHODS AND RESULTS: Over a 16-year period (1981-1997) we evaluated 1894 patients (1526 men, 368 women) with angiographically documented coronary artery disease (luminal stenosis >/=60%). For each patient the coronary angiographic results and subsequent revascularization procedures (percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery) were analysed. The study period was divided into the early angioplasty years (1981 to 1989) and the current angioplasty years (1990-1997). No gender differences in extent and localization of coronary angiographic lesions were observed. In men and women the incidence of single-vessel disease was 42% and 40%, two-vessel disease 27% and 27%, three-vessel disease 26% and 24%, and left main disease 5% and 8%, respectively (P=ns). Localization of disease in men and women was 36% and 39% for the left anterior descending coronary artery, 34% and 32% for the right coronary artery, and 27% and 26% for the left circumflex coronary artery, respectively (P=ns). There was a significant shift from multi-vessel disease towards single-vessel disease in both men and women (both P<0.001). As to subsequent management, a significant gender difference in favour of women was observed (P=0.021). Over time, the number of angioplasty procedures increased significantly from 11.6% to 23.2% for men (P<0.001), and for women from 17.6% to 28.0% (P=0.025), whereas the number of coronary artery bypass procedures decreased in men from 34.9% to 29. 5% (P=0.024) and in women from 42.6% to 30.6% (P=0.019). Referral to angioplasty (n=535) and coronary artery bypass surgery (n=616) in relation to the extent of the disease did not show any gender bias in favour of men. CONCLUSIONS: Our angiographic findings did not show significant gender differences as regards the extent and localization of coronary artery disease in patients with angiographically documented coronary artery disease. More importantly, no substantial evidence could be found for under-referral of women to subsequent therapeutic management. Therefore our study questions the presence of Yentl syndrome in the current era.

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