Scottish Surgeon Research Articles

Adverse Effects of Overdosage of Vitamins and Minerals

Throughout almost three centuries, knowledge of the uses, needs, and metabolism of trace nutrients, vitamins and minerals, has been acquired. This knowledge can be divided into five phases. The first phase occurred during a period of about 200 years and was one mainly of discovery. Animals and/or humans were noted to have diseases that were related to deficiencies. Thus, in 1753 a Scottish surgeon in the British navy showed that citrus fruit could prevent or cure scurvy, and about 200 years later ascorbic acid was isolated, synthesized, and used. Many of the trace elements were determined either to correct deficiencies or to be growth factors for animals. Discovery of knowledge continues but at a less rapid rate. The second phase, which considerably overlaps with the first, is related to determination of the mechanism of action. This required, first, study of animals, then, tissues, and, now, cells and cell components. Many biochemical pathways have been determined, and many vitamins and minerals have been identified as part of enzyme systems. Still others are to be explored and determined. The last three phases appeared irregularly but periodically, two with scientific input and one by hope, prayer, and deductin.1 The third phase was one of the determination of recommended daily requirements and allowances (RDA).

Adverse Effects of Overdosage of Vitamins and Minerals

Throughout almost three centuries, knowledge of the uses, needs, and metabolism of trace nutrients, vitamins and minerals, has been acquired. This knowledge can be divided into five phases. The first phase occurred during a period of about 200 years and was one mainly of discovery. Animals and/or humans were noted to have diseases that were related to deficiencies. Thus, in 1753 a Scottish surgeon in the British navy showed that citrus fruit could prevent or cure scurvy, and about 200 years later ascorbic acid was isolated, synthesized, and used. Many of the trace elements were determined either to correct deficiencies or to be growth factors for animals. Discovery of knowledge continues but at a less rapid rate. The second phase, which considerably overlaps with the first, is related to determination of the mechanism of action. This required, first, study of animals, then, tissues, and, now, cells and cell components. Many biochemical pathways have been determined, and many vitamins and minerals have been identified as part of enzyme systems. Still others are to be explored and determined. The last three phases appeared irregularly but periodically, two with scientific input and one by hope, prayer, and deductin.1 The third phase was one of the determination of recommended daily requirements and allowances (RDA).

Genetic aspects of cutaneous malignant melanoma.

For those of us engaged in studying familial cancer in general, and familial melanoma in particular, it is both fitting and fascinating to learn that the first patient with malignant melanoma of the skin described in the English language literature was a member of a melanoma-prone family (Norris 1820). Writing in 1820, describing a patient he had treated 3 years earlier, Dr. William Norris (an eminent Scottish surgeon of the day) reported in graphic detail the now all-too-familiar downhill course of far-advanced, widely disseminated melanoma. At the end of his vivid clinical case report, Norris noted “It is remarkable that this gentleman’s father, about thirty years ago, died of a similar disease.... This tumor originated in a mole, and it will be worth mentioning that not only my patient and his children had many moles on various parts of their bodies, but also his own father and brothers had many of them.... These facts, together with a case that has come under my notice rather similar, would incline me to believe that this disease is hereditary.” Thus, Norris both described the first melanoma-prone kindred and raised the hypothesis that its melanoma susceptibility was related to the presence of numerous moles.KeywordsDysplastic NevusAutosomal Dominant ModeFamilial MelanomaMelanoma SusceptibilityMelanoma StatusThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

H. P. Smith Award lecture: H. P. Smith's place in the history of blood coagulation.

STUDENTS OF THE HISTORY of blood coagulation would quickly agree about the outstanding contributors of the 19th century: Andrew Buchanan, a Scottish surgeon, discovered thrombin in 1845; Cornelius Pekelharing, a Dutch physiologist, in 1891 clearly separated prothrombin from fibrinogen; Olaf Hammarsten, a Swedish biochemist, purified and characterized fibrinogen in about 1880; Maurice Arthus, a French physiologist, in 1890 found that calcium was necessary for clotting; and Alexander Schmidt, an Estonian pathologist, was head of the famous coagulation group at Dorpat University that dominated coagulation research from 1875 until near the end of the century.

Edward Jenner and the First Vaccination

Of all the diseases that have afflicted mankind, one of the most devastating was smallpox. The disease is highly contagious, and prior to preventive control it spread rapidly through the population. The death rate during epidemics frequently ranged from thirty to fifty percent. Many of those who survived were hardly, if any, more fortunate than those who died, since they were often seriously crippled or blinded as well as having hideous pockmark scarring of the body and face. Records from the sixteenth, seventeenth, and eighteenth centuries indicate that only twenty percent of the population escaped the disease. In those days, a mother feared to count her children until they had contracted and survived smallpox. Centuries ago, it was noticed that persons who had recovered from smallpox very rarely caught it again, and if they did it was not fatal. Therefore, it was more advantageous to have suffered a mild case of smallpox, than to never have had the disease at all. A mild case gave protection, whereas those who had never experienced smallpox lived in fear of catching it and of the possibility of being subjected to a severe and perhaps fatal case of the disease. These observations led to the practice of inoculation, the deliberate infection with variolous (smallpox) matter taken from a pustule (puscontaining blister) of a person with a mild case of smallpox. The practice involved considerable risk to the person inoculated and also to the community. Inoculation with variolous matter from a mild case of the disease could give rise to severe smallpox. Furthermore, inoculated smallpox was contagious and sometimes caused epidemics of the disease. In 1798, Edward Jenner reported that inoculation with cowpox protected human beings from smallpox. The two diseases are closely related; but, unlike smallpox, cowpox causes a mild disease in human beings. Moreover, inoculated cowpox remains localized at the infection site of the inoculated person. Such was the dread of smallpox that Jenner's discovery was accepted with relatively little opposition. Today, because of Jennerian vaccination, smallpox has been virtually eradicated from the world, and within the next few months the World Health Organization expects to announce complete elimination of the disease. Therefore, this is an appropriate time to reflect on Edward Jenner and the eventful first vaccination. Edward Jenner was born in 1749 at Berkeley, Gloucestershire, in western England. His father, the vicar of Berkeley, died when Jenner was only five years of age, and thereafter he was brought up by a much older brother and his wife. At the age of thirteen, Jenner, who was competent in school subjects, was apprenticed as he wished to Danial Ludlow, a surgeon in the nearby town of Sodbury. During his seven-year apprenticeship, Jenner became impressed by the belief, commonly held by farm workers, that a person who had previously had cowpox was not susceptible to smallpox. He was already aware that cowpox caused only a mild disease in human beings, in marked contrast to the horrors of the dreaded smallpox. Jenner himself had personal experience with smallpox. When he was eight, he was inoculated with smallpox, and then shut up in a so -called inoculation stable until the disease had run its course. The experience changed him from a healthy boy into a sickly one, and a number of years passed before he regained good health. On occasion his brother had to withdraw him from school and tutor him at home because of his poor health. It is believed that Jenner's suffering from inoculation contributed to his interest in finding a better method to prevent smallpox. After completing his apprenticeship in 1770 Jenner, on the recommendation of Ludlow, went to London for advanced study with the eminent Scottish surgeon, John Hunter. Hunter was very much impressed by Jenner's ability, and asked him to remain in London and practice surgery. Jenner declined the invitation. How much his purpose to investigate cowpox and smallpox had to do with this decision is not known. In 1773, at the age of twenty-four, Jenner returned to Gloucestershire to practice surgery in his home town of Berkeley. At that time medicine

THE CASE OF A MALE CHILD BORN WITHOUT AN ANUS (C. 1745)

The case history below written by a Scottish surgeon is a good example of the linguistic style of mid-eighteenth century clinical presentations in the English language. Paul of Aegina, a seventh century Byzantine physician, is usually credited with having successfully incised the perineum of an infant without an anus1 The first recorded American operation was performed in Flemingsburg, Kentucky, in 1800 by Dr. J. P. Campbell.2 The defect was an anorectal atresia without fistula, and the child was living three months after operation. Mr. James Jamieson of Kelso, Scotland gave this description of his unsuccessfully treated patient: Some years ago Mrs. Hannah, midwife in this Town was called to one Mrs. Stevenson in Plowland five miles distant from this Place, whom she delivered of Twins, the one Female, the other Male; and discovering in the later no Appearance of an Anus, came home and sent me to see the Child, whom I found otherwise sprightly, and seemingly in perfect Health, but not the least Vestige of an Anus to be seen or felt, but equally firm and solid from the Coccix (sic) to the Scrotum: whereupon I told the Grandmother, who only was acquainted therewith by the midwife, that it was preternatural, and that though I had twice seen the Anus covered by a membrane, which was easily cured, I could not propose to do the like in this; but if she pleased, I should try to reach the Gut by Incision which she, with the mother's Consent fondly agreed to: whereupon I made an incision pretty deep in the most reasonable Part, then introduced my little Finger into the Wound, to find the Gut, but in vain.

MACEWEN OF GLASGOW: THE STORY OF A SCOTTISH SURGEON

Medical Journal of AustraliaVolume 2, Issue 12 p. 441-441 Current Comment MACEWEN OF GLASGOW: THE STORY OF A SCOTTISH SURGEON First published: 01 September 1957 https://doi.org/10.5694/j.1326-5377.1957.tb58093.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume2, Issue12September 1957Pages 441-441 RelatedInformation