Sunday 28 June 2015

Understanding of CNS Tuberculosis- Three Landmark Papers

It is amazing and inspiring to see the excellent contributions of founders of medicine. While working on CNS tuberculosis I found that our present understanding of the tuberculosis is based on the works of physicians who existed about a century ago. Their contributions are immense and very encouraging to us.  The following three landmark papers helped in the understanding of aetiology , pathogenesis and treatment of tuberculosis of the central nervous system.

1. Green PH. Tubercular meningitis. Lancet 1836; II: 232–35.

2. Koch R. Die aetiologie der tuberculosis.
Berlin Klinische Wochenschrift 1882; 19: 221–30.

3. Rich AR, McCordock HA. The pathogenesis of tuberculous
meningitis. Bull John Hopkins Hosp 1933; 52: 5–37.

Before the demonstration of a tuberculous bacteria by Robert Koch, Green PH had published a paper in Lancet in 1836, describing a new diagnosis called tubercular meningitis.



May 14, 1836

Volume 26
Number 663
p225-256
Originally published as Volume 2, Issue 663



Green PH. Tubercular meningitis. Lancet 1836; II: 232–35.

In this paper Green P.H., President of the Society of Foreign Physicians, Paris, France, coined the new term in medicine " Tubercular Meningitis. In this paper there is description of clinical presentation of tubercular meningitis and acute hydrocephalus and post mortem findings of the patients showing caseation and exudates.


Koch R. Die aetiologie der tuberculosis. Berlin Klinische Wochenschrift 1882; 19: 221–30.

Robert Koch (1843-1910) was a German master of medicine. He got Nobel Prize in Medicine. he is regarded as Founder of science of Bacteriology. In 1876, he demonstrated Anthrax bacillus and in 1882 he demontrated tubercle bacillus.

          Robert Koch: German physician & Pioneering Microbiologist ( demonstated bacteria causing Anthrax, Cholera ans tuberculosis)




Rich AR, McCordock HA. The pathogenesis of tuberculous meningitis. Bull John Hopkins Hosp 1933; 52: 5–37.

Arnold Rice Rich (1893-1968) was born in Birmingham, Alabama in USA on March 28, 1893. He studied at University of Virginia and John Hopkins. He worked as Professor of pathology at John Hopkins , Baltimore, USA. He was excellent teacher and researcher. His contribution in medical sciences is immense. His contributions include the understanding of pathology of jaundice, pathogenesis of tuberculosis.

                                                                       A R Rich
                                Source http://www.medicalarchives.jhmi.edu/images/rich.jpg

This paper by AR Rich is the outcome of clinical and animal experiments. this paper described the occurrence exudates in tuberculosis.



Sources:

http://www.nasonline.org/publications/biographical-memoirs/memoir-pdfs/rich-arnold.pdf

Robert Koch: centenary of the discovery of the tubercle bacillus, 1882
ALEX SAKULA, From Redhill General Hospital, Surrey
Thorax 1982;37:246-251

Wikipedia: Robert Koch

http://www.medicalarchives.jhmi.edu/images/rich.jpg

http://www.medicalarchives.jhmi.edu/papers/rich.html

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