Wednesday, September 01, 2010

Physiology on the sub-way map of science

By way of Chad Orzel and Derek Lowe I came upon Crispian Jago's wonderful sub-way map of science. While he actually presents his quite fantastic map as : "500 Years of Science, Reason & Critical Thinking via the medium of gross over simplification, dodgy demarcation, glaring omission and a very tiny font," I have to take umbrage for physicians and physiologists everywhere. Albrecht von Haller wasn't the only physiologist who did anything in the 18th century, and I think we existed, at least partially separate from "Natural History" in the 16th and 17th centuries. Above all, the science of Medicine certainly did not turn into "21st Century Microbiology!"

How, then, should this be put right?

Well, with a blog-post obviously. But first microbiologists deserve a line of their own, even if it will intersect with the line of medicine in quite a number of places. This is their problem. The medicine-line should be renamed "Medicine and Physiology", neurology is either a medical speciality or a branch of physiology. It could, of course, be argued that neuroscience/neurology/psychology should have a line of its own, but I leave that to the neuroscientists.

The freed-up line called "Medicine and Physiology" should start at Vesalius. Unless you want to go back to earlier times. Given the extent of the map, it may be wise to stop at the 16th century.

Hooke, Harvey, Malpighi and some others should be included on this new line. Now to the additions:

16th Century
  • Paracelsus (founding father of toxicology and early enlightened surgeon who suggested that wounds shouldn't be cauterised).
  • Bartolomeo Eustachi (One of the first anatomists, although his work wasn't published until 1714: Tabulae Anatomicae).
  • Ambroise Paré (1545: Wrote the first non-Latin/Greek textbook in surgery and was one of the original great experimentalists in surgery).

17th Century
  • Olof Rudbeck (1651: described the lymphatic circulation).
  • Lorenzo Bellini (1662: Exercitatio Anatomica de Structura Usu Renu).

18th Century
  • F. Pourfois du Petit (1727: shows vasodilation in the eye following denervation).
  • Stephen Hales (1733: Haemastatics).
  • Giovanni Mrogagni (1761: The seats and causes of disease).
  • John Hunter (1794: A treatise on blood, inflammation and gun-shot wounds).
  • Alexander Schulmansky (1783: De structura renum).

19th Century
  • Hanaoka Seishu (1804: first known use of anaesthesia).
  • Charles Bell (1811: sensory and motor nerves).
  • Richard Bright (1827: renal disease and oedema).
  • Jean Louis Marie Poiseulle (1828: measures blood pressure, 1841: fluid dynamics in small tubes).
  • William Bowman (1842: On the structure and use of the Malpighian body of the kidney).
  • Carl Ludwig (1842: describes glomerular filtration as physical forces).
  • Emil du Bois-Raymond (discovers the neural action-potential).
  • Adolf Fick (1855: describes law of diffusion that bears his name, and later used it to measure cardiac-output).
  • Karl von Vierordt (1855: measures the arterial pulse pressure).
  • Jakob Henle (1862:Described the loop of Henle's, and together with Robert Koch formulated the "Henle-Koch postulates").
  • William Gull (1872: microvascular disease).
  • Camillo Golgi (Described large parts of the nervous system and received the Nobel Prize in 1906. In addition he described how the distal tubule returns to the originating glomerulus, an important finding in kidney physiology).
  • Scipione Riva-Rocci (1896: Presented his method for measuring blood pressure, which is still used today).
  • Robert Tigerstedt (1898: showed the existence of Renin the first identified hormone).

20th Century
  • Victor Henri (1901: Describes the Henri-Michaelis-Menten equation for enzyme kinetics).
  • Leonor Michaelis and Maud Menten (1913: provides their insight on enzyme kinetics).
  • Ernest Starling (Describes the exchange of fluid over the capillary membrane in the Starling equation, then goes on to describe the Frank-Starling law of the heart, and then goes on to describe the idea of hormones).
  • Otto Frank (Describes the Frank-Starling law of the heart).
  • August Krogh (Treated diabetes with insulin).
  • Ewald Hering (1924: Discovered the baro-receptor and their role in blood pressure regulation).
  • Joseph Wearn & Alfred Richards(Establishes glomerular ultrafiltration as described by Carl Ludwig by micropuncture).
  • Werner Forssman (1929: performs the first human heart catheterisation, on himself).
  • Homer Smith (Describes the nephrons as autonomous working units in the kidney, and much more).
  • Harry Goldblatt (1934: Establishes the first experimental model of hypertension).
  • Arthur C. Guyton (1955: proposes that cardiac out-put is governed by periferal resistance, measures interstitial pressure and shows that it is negative, and goes on to show how the kidney regulates blood pressure).
  • Carl Gottschalk (1959: shows that the concentrating mechanism in the kidney is dependent on a counter-current system).
  • Edward D. Freis (1960: presents the first ever double blinded, controlled clinical trial).
  • Robert Furchgott (1980: Discovers the endothelial derived relaxing factor, and goes on to show that this is nitric oxide in 1986).

And then there are any number of still living physicians and physiologists who could be included.

Before it, in the end, turns into "21st Century Medicine and Physiology" and nothing else.

At least, that is the view of a nephrophysiologist. I know. There are physiologists and physicians who aren't into kidneys, but I always try to have hope: They will convert in the end.