Section 1 -

Antiquity to Liebow- Milestones in Pulmonary Pathology David Dail Virginia Mason Medical Center Seattle

Introduction Many choices of what to highlight in 30 minutes All in room might approach topic differently Impossible to note all significant individuals and achievements All will feel someone very important to them has not been mentioned Highlights (of my choosing) have been selected Ancient Greeks Asklepios (latin Aesculapius) Probably a real man, lived about 1200 BCE, mentioned by Homer in Iliad. Became God of Medicine, son of Apolla Two daughters-Panacea-diety for treatment of disease -Hygeia-diety for health and prevention of disease Temples became houses of healing (early hospitals) Early medicine-mysticisim, magic and potions Later-physical: baths, massage, exercise, diet, blood letting Hippocrates (460-377 BCE) school. Air, water and "places" Galen of Pergamon (130-200 CE) choleric, melancholic, phlegmatic, sanguine Dark ages (400/500-1500 CE)…Renaissance awakening of scientific thought Dissection Alexandria (Alexander died in 323 BCE) 13th century-University of Bologna Egyptians (and South American natives)-TB, dusts, tumors "Silicosis is as old as mankind" Socioeconomic changes-urbanization, crowding, poverty, sanitation, dusts, wars, injuries, travel, trade. "Before 1800s, most Europeans lived their whole lives within 10 miles of their birthsite." Microsope-van Leeuwenhoek (1632-1723) Cell theory-Virchow Germ theory-Pasteur, Kock, Jenner, Lister Laennec (1781-1826)-invented stethoscope, wrote first treatise on Disease of the Chest. Selected Topics Plagues TB used to illustrate more modern role. Lung Tumors 1912 Adler found 374 cases in world's literature 1926 Barnard defined oat-cell carcinoma, differentiated from lymphosarcoma. 1928/1929 Mesothelioma debated…as possible WHO tumor classifications-1967, 1981, 1999 Raymond Yesner AFIP Fascicles-1952 (Liebow), 1980 (Carter and Eggleston), 1995 (Colby, Koss, Travis) Anatomy of lung William Snow Miller Frederick Low Ewald Weibel Others-Wang, Kuhn, Lauwreyns, Thurlbeck, Hogg... Herbert Spencer S. Donald Greenberg Averill A. Liebow (1911-1978) Forward 1st edition Spencer "At first glance the lungs may seem uncomplicated, but many wise men have gone astray in their labryinth." Later: "The lungs are a simple bellows …only to a simple fellow." Atomic bomb casualites 1945, Encounter with Disaster, 1965 1952 First Fascicle on Tumors of the lower respiratory tract. 1953 Lung musculature, high and low blood flow to lung Casts-injection and corrosion, Gough-Wentworth whole sections 1956 Sclerosing Hemangioma (7 cases with Hubbell), (follow-up 1980 51 cases-Katzenstein, Gmelich, Carrington) 1958 Pulmonary alveolar proteinosis/PAP. (27 cases, with Rosen) 1960 Bronchiolo-alveolar carcinoma/BAC 1960 Chemodectomas (19 cases, with Korn, Bensch, Castleman) 1965 Desquamative interstitial pneumonia/DIP (18 cases with Steer and Billingsley) 1966 Limited Wegener's granulomatosis (15 cases with Carrington) 1967 (Pulmonary veno-occlusive disease, 16 cases with Carrington) 1969 (Chronic) eosinophilic pneumonia/CEP (16 cases with Carrington) 1971 Benign clear cell sugar tumor (12 cases with Castleman) 1972 Lymphomatoid granulomatosis/LG/LYG (40 cases with Bloor and Friedman) (follow-up 1979 152 cases -Katzenstein, Carrington, Liebow) 1973 Plasma cell granuloma/PCG (40 cases with Bahadori) 1973 Bronchocentric granulomatosis/BCG (9 cases), Necrotizing sarcoid granulomatosis/NSG (11 cases) (follow-up 1975 BCG, MI, hypersensitivity reactions to fungi-Katzenstein, Liebow, Friedman) 1973 (Bronchiolitis obliterans, 80 cases with Gosink and Friedman) 1974 UIP. BIP, DIP, LIP, GIP 1975 (Lymphangioleiomyomatosis/LAM, n= 28 cases with Corrin and Friedman) 1976 Blue bodies (19 cases) 1977 Pulmonary hyalinizing granuloma/PHG (20 cases with Engleman, Gmelich, Friedman) 1981 (Pulmonary eosinophilic granuloma/PEG…PHX/LCG/LCH, 100 cases,with Friedman and Sokoloff) 1983 Intravascular bronchioloalveolar tumor/IVBAT…EH/PEH (20 cases with Dail…), abstract 1975 ( ) =expanded but did not originally define entity Dedications (From 1995) Bibliograpy Kiple KF. The Cambridge world history of human disease. Cambridge:Cambridge. 1993. Byers JR. From Hippocrates to Virchow: reflections on human disease. Chicago: ASCP. 1988. Loudin I, ed. The Oxford illustated history of western medicine. Oxford: Oxford University Press. 1997. Malkin HM. Out of the mist: foundations of modern pathology and medicine during the nineteenth century. Berkeley: Vesalius. 1993 Harrison M. Disease and the modern world: 1500 to the present. Cambridge: Polity. 2004. Diamond J. Guns, germs and steel: The fates of human societies. New York: WW Norton. 1997 MacCallum WG. A text-book of pathology. Philadelphia: WB Saunders 4th ed 1929. (1st ed 1916). Ewing J. Neoplastic diseases: a treatise on tumors. Philadelphia: WB Saunders. 3rd ed. 1928. Winternitz MC, Wason IM, McNamara WC. The pathology of influenza. New Haven, Yale University. 1920. Morse D, Brothwell DR. Ucko PJ. Tuberculosis in ancient Egypt. Am Rev Respir Dis 1964;90:524-541. Murray JF. The white plague: down and out, or up and coming? Am Rev Respir Dis 1989;140:1788-1795. Miller WS. The lung. Springfield, IL: C.C. Thomas. 2nd ed. 1947. Spencer H. Pathology of the lung (excluding pulmonary tubercuosis). Oxford: Pergamon. 1962 (first edition). Glenn WWL, Liebow AA, Lindskog GE. Thoracic and cardiovascular surgery with related pathology. New York: Aplleton-Century-Crofts. 3rd ed. 1975. Liebow AA. Tumors of the lower respiratory tract. Washington DC: Armed Forces Institute of Pathology. 1952. Bloor CM. In rememberance of Averill A. Liebow (March 31, 1911 - May 31, 1978). Am J Pathol 1978;92:577-580. Lindskog GE. Averill Abraham Liebow (1911-1978): A colleague's tribute. Yale J Biol Med 1981;54:127-137. Walker Smith GJ. Averill Abraham Liebow: Contributions to pulmonary pathology. Yale J Biol Med 1981;52:127-137. Dail DH, Hammar SP, Colby TV. Pulmonary pathology tumors. New York: Springer. 1995 Dedications.