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Intensivist, pulmonologist | Husband, Dad² | made @OnePagerICU @CritCareTime | passionate about MedEd & MedTech innovation @nickmark.bsky.social

Nov 9, 2021, 23 tweets

Medicine has thousands of eponyms. Most are named for doctors but a few eponyms honor patients.

For example, Bacitracin, named for the bacteria Bacillus subtilis var Tracy, was first identified in a little girl “Tracy I.”

New post & medical history🧵
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onepagericu.com/blog/magnanimo…

Hieronymus Karl Friedrich Freiherr von Münchhausen, a German Baron, was legendary for telling stories of his adventures in the Russian Cavalry during the Russo-Turkish War.
(even the dogs look entertained!)
Notably he was *NOT* regarded as a liar but as a great story-teller!
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A German writer & con-artist, Rudolf Erich Raspe, created a fictional character Baron Munchausen loosely based on Baron Münchhausen (note the spelling: u not ü)

Munchausen had incredible adventures such as riding a cannonball, fighting a 40 foot crocodile, & going to the Moon
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The real baron Münchhausen was not happy about his fictional namesake
He unsuccessfuly sued Raspe, but the fictional Munchausen was a success, with >10 editions in 4 languages by 1790
Münchhausen died a recluse, refusing to host parties or tell stories, bitter about his legacy
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He would have been pissed when Asher described 'Munchausen Syndrome'
"Like the famous Baron...the persons affected have always travelled widely; & their stories, like those attributed to him, are both dramatic & untruthful...The syndrome is respectfully dedicated to the Baron"
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In short, Muchausen’s syndrome & its derivates - Munchausen’s by proxy & Munchausen’s by internet - don’t paint a very flattering picture of the real Münchhausen, who was by all accounts a generous host & great story-teller.
Maybe it’s best to retire this (misspelled) eponym.
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The story of Henrietta Lacks and the eponymous HeLa cells taken from her is already well known.
One interesting fact that I uncovered researching this was that in August 1960, Korabl-Sputnik 2 carried HeLa cells into orbit. Thus HeLa were likely THE FIRST HUMAN CELLS in space!
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French internist Armand Trousseau described an association between GI cancer & migratory thrombophlebitis noting “the frequency with which cancerous patients are affected with painful oedema of the…extremities.”
This paraneoplastic phenomenon was called "Trousseau's Sign."
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Soon after describing this finding, however, Trousseau himself developed thrombophlebitis & told a confidant, “I am lost; a phlegmasia which showed itself…leaves me no doubt about the nature of my affliction."
His story is described beautifully @NEJM: pubmed.ncbi.nlm.nih.gov/12374880/
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Trousseau was not the only physician to describe a disease in themself. Julius Thomsen described a myotonia in himself & family members:
“after a fright, or in an unexpected joyous movement, this convulsive constriction occurs in all limbs…the victim can not stand upright…"
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The disease - Myotonia congenita - also called Thomsen's disease, is due to a chanellopathy in CLCN1.

An analogous mutation causes the "fainting goat" syndrome. (This is a misnonmer: the goats are awake but their muscles spasm when startled/afraid)

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Another physician to diagnose himself was South African cardiologist Leo Schamroth.
While critically ill with endocarditis he had the presence of mind to observe a subtle change in his nail beds.
The change in "Schamroth Window” remains a useful diagnostic maneuver.
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I highly recommend reading Schamroth’s article “Personal Experience” (if only for his description of hospital food).

Aside: He also has one of the oddest wikipedia entries (and I read/edit a lot of wiki)…
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ID doctors apparently have a long history of intrepid self-diagnosis.

Dr. Howard Ricketts became famous after research that involved injecting himself with blastomycoses “until he became sick enough to realize that this was an experimental procedure not to be repeated.”
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Ricketts went to study Rocky Mountain Spotted Fever, identifying the pathogen once again by injecting himself.
The organism was later named: Rickettsia rickettsii. Unfortunately, he tempted fate one too many times, & died of typhus (Rickettsia prowazakii) Mexico City in 1909.
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His colleague, Stanislav von Prowazek, also died while trying to understand typhus.
The bacteria that killed both intrepid ID docs - Rickettsia prowazekii - is named for the heroic contributions of both Ricketts & Prowazek.
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Another, ID hero was a Peruvian medical student Daniel Alcides Carrión García who, in 1885, injected himself with Bartonella bacilliformis.

In 1870 Carrión had watched ~1/4 of his hometown die from “Oroya Fever” and was fixated on understanding this enigmatic disease.
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Carrión theorized that 2 different diseases, an acute illness known as "Oroya fever" & a chronic skin rash known as the Peruvian Wart (“veruga peruana”), were actually manifestations of one infection.

To test his hypothesis injected himself with bacteria from the "wart"
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Over the next 5 wks, he carefully documented his symptoms - fevers, hemolytic anemia that characterized “Oroya Fever" - proving that the 2 diseases were in fact caused by a single bacteria, later known as Bartonella.

The infection now known as Carrión's disease after him.
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40 days after injecting himself to prove his theory, Carrión died from his eponymous disease.

More than a century after his death, Carrión is still celebrated a hero in Peru. To this day, October 5th, is remembered as the Day of Peruvian Medicine in his honor.
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Finally, the Great Satchmo, “King of Jazz” Louis Armstrong, in 1935 sustained a rupture of the orbicularis ori muscle from his forceful trumpet playing. This injury, eponymously called the “Satchmo Syndrome,” obligated Louis to put down his trumpet for much of the next year.
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I hope you've enjoyed this rambling thread on stories of patient eponyms: from Bacitracin to Jazz.

If you want to read more of these stories, check out my blog on the subject: onepagericu.com/blog/magnanimo…

And if you know any examples I missed, please do share in the comments!
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For those interested in all the patient eponyms that I uncovered - here's a summary table.
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