Glossary

(See Iodide Tincture; Syphilis).

Sources: Cardenal, 1947; Hawley, 1950; Houaiss, 2001; Jackson, 1920/1935?; Koogan-Houaiss, 2004; Paulier, 1882; www.102; www.109; www.110; www.111; www.112; www.113; www.114; www.115; www.138.

Iodide tincture: a solution obtained by diluting iodine in alcohol. Chemical element of the halogenes family, represented by the symbol I and atomic weight 53, iodine, in high concentrations, is poisonous and may cause serious damages to the skin and tissues. Diluted in alcohol it has been used in medicine as antiseptic. According to Paulier, by the end of the 19th century iodine tincture was principally employed for its revulsive properties, being rubbed or applied with cotton over the skin.

(See Iodine).

Sources: Encyclopædia Britannica, 2001; Houaiss, 2001; Paulier, 1882; Stedman, 1979.

Iodoform [CHl ]: a substance, now in disuse, developed in 1822 by 3

the French pharmacist and chemist Georges-Simon Serullas (1774-1832), iodoform presents itself in crystallized form as shining sulphur-yellow pellets that evaporate at room temperature and volatilize with vapor. It contains 96% of iodine in its formulation, having a pungent and unpleasant smell. Used as topical anesthetics and antiseptic of prolonged action, it has antimicrobial effect upon mucous membranes reducing the secretion of lesions. A result of the reaction of iodine with alcohol and some alkaline metal, it may be prepared as oil, paste or hydrosoluble substances such as distilled water or physiological serum. In the past it was very much used in endodontic treatments of channels, but was progressively abandoned because of the toxic properties of iodine, its unpleasant smell and taste, and because it changes the color of teeth. (See Iodine).

Sources: Cardenal, 1947; Hawley, 1950; Houaiss, 2001; Jackson, 1920/1935?; Koogan-Houaiss, 2004; Paulier, 1882; www.116; www.117; www.124; www.177.

 

K

Kanaka: native or inhabitant of Hawaii. It also designates natives from New Caledonia and other islands of Melanesia, in the Pacific Ocean.

Sources: Ferreira, 1999; Houaiss, 2001; Webster, 1971.

Kaposi, Moritz Kohn: Hungarian doctor born in Kaposvár, on October 23, 1837. After his graduation at the Faculty of Medicine of Vienna, in 1861, he was named assistant of Ferdinand von Hebra (1816-1880), a famous Austrian dermatologist, with whom he worked from 1862 to 1867. A prolific writer, Kaposi made several original contributions to dermatology, dedicating himself to the clinic, pathologic and therapeutic aspects of diseases with cutaneous manifestations. He was especially interested in lesions caused by syphilis in the skin and mucous membranes, as well as in the etiology and treatment of that disease. He undertook studies of dermatitis herpetiformis (first described by von Hebra), lymphoderma perniciosa and lichen ruber moniliformis, diseases characterized by him as specific entities. Together with Hebra and other dermatologists he produced descriptions of lupus erythematosus of the skin, of rhinosclerome and rhinophyma, besides publishing papers on dermatology ("On diseases of the skin, including the exanthemata", 18661880; "Lehrbuch der Hautkrankheiten", 1874-1877). In 1875 he assumed the chair that had been occupied by his master at the University of Vienna and in 1879 was named director of the dermatological clinic of the same city. Married to Hebra's daughter, who was a catholic, Moritz Kohn, a Jew, adopted the surname Kaposi as a homage to his birthplace. Among the various eponyms associated with the Hungarian doctor, Kaposi's sarcoma must be mentioned, a rare type of cancer described by him in 1872, nowadays associated with Aids. Kaposi died in Vienna on March 6, 1902.

(See Erythematous lupus; Hebra, Ferdinand Ritter von; Lichen).

Sources: Encyclopædia Britannica, 2001; Larousse, 1971; www.190.

Kava-kava: popular name of an herb of the family Piperaceae, whose scientific designation is Piper methysticum. The powder prepared from its roots has aphrodisiac, analgesic, anesthetic (local), tranquilizing, anti-convulsive, anti-depressive, anti-inflammatory, spasmolythic, narcotic and relaxing properties. Prohibited in certain countries (e. g., France), it is indicated for states of agitation, anxiety, depression, stress, insomnia and tension. The use of cava-cava must be avoided in cases of Parkinson's disease, pregnancy, milk-feeding and by users of anti-depressives, anxiolythics, anti-psychotics or other substances that cause depression of the central nervous system (hypnotics, sedatives, etc.). The use of high doses for a long period of time may result in inflammation of the body and eyes. Initially, it has a stimulant effect, but leads to depression and even to the paralysis of the respiratory system. It may also provoke severe damages to the liver. It was prescribed during a long time for the treatment of gonorrhoea, incontinence, vaginites and other diseases.

Sources: www.103; www.131.

Kimball, John Hancock: North American doctor born on July 9, 1832, in a part of the state of Maine later on annexed to Bridgton, where he died on June 20, 1902. After he graduated in Medicine at Harvard Medical School in 1857, he participated in the North American Civil War (1861-1865), having been twice recruited as army surgeon of the Union. Accompanied by his daughter he arrived in Hawaii on June 11, 1882. In October of that same year he was named doctor of the U. S. Government for the Hilo district, where he remained until May 1888. Transferred to Honolulu, he became responsible for the dispensary of the Hawaiian capital, which he did until January 1890, when he was made president of the Health Council of the Kingdom of Hawaii. He resigned after nine months of work, returning to the United States in the beginning of 1891.

Sources: www.193.

Klebs, Edwin: German doctor and bacteriologist born in Koenigsberg on February 6, 1834, died in Bern on October 23, 1913. Famous for his original observations on infectious diseases, based on bacteriology, he conducted researches on tuberculosis, malaria, anthrax and syphilis. In 1879, together with Italian doctor Tommasi Crudeli, he described Bacillus malariae, a microorganism they considered to be the cause of malaria. Klebs became especially notorious for his description of the bacillus of diphtheria, in collaboration with Friedrich August Johannes Löffer, in 1884. Assistant of Rudolf Virchow (1821-1902) at the Berlin Institute of Pathology between 1861 and 1866, he lectured pathological anatomy in several European universities and, from 1896 on, at Rush Medical College in Chicago. Besides monographs and articles, he published a handbook on pathological anatomy (1869-1876) and a treatise on general pathology (1887-1889).

(See Crudeli, Tommasi Corrado).

Sources: Encyclopædia Britannica, 2001; Larousse, 1971; www.165.

Koch's Lymph: sterile liquid extracted from a culture of tuberculosis bacilli, employed in the diagnostic of that disease. Also called tuberculin, it was used, without success, by Robert Koch (1843-1910) in the treatment of tuberculosis.

(See Tuberculosis).

Sources: Houaiss, 2001; Larousse, 1971; Landouzy & Jayle, 1902; Littré & Gilbert, 1908.

Koebner, Heinrich: German dermatologist (1838-1904), considered the founder of clinical dermatology in universities and the pioneer of dermatology in Breslau (Prussia). He has his name associated to a phenomenon he described in 1872: the isomorphic reaction or effect, also known as Koebner's phenomenon, occurring in certain types of dermatoses, principally psoriasis, as a response to traumas such as excoriations, burns, pressure upon the skin, originating typical lesions in the affected parts.

Sources: Stedman, 1979; www.192; www.191; www.174; www.208.

 

L

Laudanum: generic name of a medicament, widely used in Adolpho Lutz's times, which has opium as its base element and, due to its sedating properties, it is used in external applications and sometimes internally. Without further qualification, it designates the formulation created by the English physician Thomas Sydenham (1624-1689), a wine or tincture of opium composed by officinal opium (200 g), saffron (100 g), cinnamon (15 g), clove (15 g) and Grenache's wine (1,600 g).

Sources: Ferreira, 1999; Houaiss, 2001; Koogan-Houaiss, 2004; Pinto, 1949.

Leloir, Henri Camille Chrysostôme: French dermatologist who was born in Tourcoing on November 30, 1855 and died in Paris on June 18, 1896. He studied first at the Faculty of Medicine at Lille and later in Paris, where he obtained his doctorate in 1881. He is principally recognized for his researches on cutaneous tuberculosis, trophodermatoses - dermatoses due to problems of nutrition of the skin - and leprosy, which he studied in Norway, Italy and southern France. He was one of the defenders of leprosy transmission by means of inoculation of its agent by mosquitoes, as he believed that the epidermis and the hypodermis constituted barriers to the entrance of the microorganism that caused the disease, preventing direct contagion through simple contact. Head of Saint-Louis Hospital clinics in 1882, he lectured dermatology and syphilis in Lille, under the condition of professeur agrégé from 1884 on, being named professor of the faculty the following year. Leloir's disease, also kbown as lupus vulgaris erythematoides, is a form of cutaneous tuberculosis keeping some resemblance to lupus erythematosus. (See Leprosy; Tuberculous Lupus).

Sources: www.178; www.204.

Leprosy (Hanseniasis): in Portuguese also called hanseníse, elefantíase-dosgregos, gafa, gafeira, gafo, guarucaia, lazeira, macota, macutena, mal, malbruto, mal-de-cuia, mal de Hansen, malde-lázaro, mal-de-são-lázaro, mal-do-sangue, mal-morfético, morféia. In Brazil, the substitution of the word "lepra" by "hanseniasis" was initially proposed in the 1970's, in the State of São Paulo, in the belief that this would help to undo the millenary stigma conferred upon sufferers of that disease. The proposal was rendered official by the federal government by means of Decree 76078, of August 4, 1975, which also altered the denomination "Divisão Nacional de Lepra" to "Divisão Nacional de Dermatologia Sanitária" and of "Campanha Nacional contra a Lepra" to "Campanha Nacional contra a Hanseníase". Twenty years later, through Law 9010 of March 29, 1995, it was determined by the federal government the substitution of the term "lepra" and its derivates in the language employed in official documents of the centralized and decentralized administration of the Union and its member States. A chronic, infectocontagious disease, curable since the years 1940-1950, it is caused by Hansen's bacillus (Mycobacterium leprae), a microorganism identified by the Norwegian doctor Gerhard Henrik Armauer Hansen (1841-1912), in 1874. It manifests itself by means of anesthesic cutaneous lesions and neuritical disturbances, evolving, according to the patients' resistance, either to spontaneous regression or to the progressive worsening of the clinical cadre, with gradual engagement of the skin sensitive nerves and nervous trunks, of the nasal and otopharyngolaryngeal mucous membranes, eyes and viscera. The transmission of the disease still holds obscure aspects, but it is admitted that it occurs, according to some physicians, mainly under conditions of prolonged and intimate contact: the bacilli eliminated by means of spittle, nasal mucus and ulcerated lesions may reach the skin or the mucoses (mainly the nasal ones) of healthy persons and penetrate the organisms through chinks there present. The infection by the bacillus, however, does not necessarily imply the acquisition of the disease, which depends on the degree of resistance of each individual and from peculiarities of Hansen's bacillus: high infectivity and low pathogenicity, that is, the capacity of infecting a large number of people, but of developing as a disease in a small number of infected persons. Nowadays, four clinical forms of the disease are recognized: undetermined, tuberculoid, dimorphic and Virchowian. In order to simplify the diagnostic, the World Health Organization has adopted another classification, distinguishing the categories bacilliferous (multibacillary) and non-bacilliferous (paucibacillary). The former, responsible for the chain of transmission, when untreated, is characterized by the presence of a large number of bacilli in the infected individual. In the second category, Mycobacterium leprae occurs in scarce numbers, inclusively presenting negative results in laboratorial exams. Along the 19th th and 20 centuries there have been several attempts at establishing a precise classification, accounting for the different clinical manifestations of leprosy, from the clinical, bacteriological, immunological, histopathological and evolutionary point of views. According to François Henri Hallopeau (1842-1919), the differentiation established by Robinson, in 1819, between tuberculous and anesthesic leprosy had first been accepted by Daniel Cornelius Danielssen (1815-1894) and Carl Wilhelm Boeck (1808-1875), and afterwards by several other authors. In addition, a mixed form was moreover accepted, in which both forms described by Robinson manifested themselves. Using parameters not very different from those of Robinson, Henri Camille Chrysostôme Leloir (1855-1896) distinguished the tegumentary and the nervous forms; Gerhard Armauer Hansen and Carl August Looft (1863-1943), the tuberous and the maculo-anesthesic forms. Adolpho Lutz, by the end of the 1880's, recognized three modalities of leprosy - tuberous, nervous and maculous - in addition to mixed forms. Paul Gerson Unna (1850-1929) classified the cutaneous manifestations of leprosy into two groups: lepromas and neuroleprides (cutaneous eruption following a neuritis due to Hansen's bacillus). In the ensuing years several other arrangements and terms for the various manifestations of hanseniasis were proposed.

(See Hansen, Gerhard Henrik Armauer; Mycobacterium leprae).

Sources: Brouardel & Gilbert, 1896; Charcot & Bouchard, 1899-1905; Claro, 1995; D'Elia, 1926; Ferreira, 1999; Houaiss, 2001; Littré & Gilbert, 1908; Moreira, 2003; Sarno, 2003; Veronesi, 1982; www.68; www.202.

Lichen: in dermatology, generic designation of several types of dermatoses characterized by more or less pruriginous papulous eruptions, with skin thickening and asperity and disposition similar to that of lichens growing over rocks. The use of the term lichen was the object of intense polemics among 19th century dermatologists. Ferdinand von Hebra (1816-1880) divided the diseases thus called into two groups - scrophulous lichen, developing on the trunk, dorsum and low abdomen, under the form of more or less voluminous, flattened papulae, in groups or plates, of slow evolution, with occasional complications; and lichen ruber, with the varieties acuminatus, and planus. In lichen acuminatus he included the eruptions whose papulae are conical and extend over the entire body surface. In lichen planus, he united the lesions consisting of shining, dry and violet papulae, generally very resistant and pruriginous, especially located on the neck, forearm and inferior regions of the abdomen. It befell to a disciple of Hebra, Moritz Kaposi (1837-1902) the tentative of establishing some order in the classification of lichens. According to that Hungarian doctor, the lichen ruber described by Hebra, with its varieties acuminatus and planus, were nothing else than the lichen planus established by Erasmus Wilson (18091884) in 1869. Kaposi's definition ended up by supplanting Hebras's and a more correct knowledge of the etiology of the several types of lichens resulted in the reclassification of many of them in the following decades. Now lichen ruber acuminatus is described as pityriasis rubra pilaris. Lichen ruber and lichen planus are still considered synonyms. (See Lichen acuminatus; Lichen obtusus; Lichen planus; Lichen ruber).

Sources: Cardenal, 1960; D'Elia, 1926; Ferreira, 1999; Houaiss, 2001; Murray, 1910; Stedman, 1979; www.152; www.153.

Lichen acuminatus: also known as Hebras's lichen in older sources (such as Cardenal, 1947 and D'Elia, 1926), where it was defined as a variety of lichen ruber. Stedman (1979) considers lichen ruber, lichen acuminatus, Wilson's lichen and lichen planus as synonyms, preferring to employ this last term to designate the disease characterized by eruptions of flattened, shining and violet papulae on flexory surfaces, male genitalia and the mouth mucous membranes. It may also form linear groups and hypertrophied lesions on the legs. According to other more recent sources, lichen acuminatus is one of the names given to the pityriasis rubra pilaris, which, by its turn, is also known as psoriasiform lichen, Devergie's disease, or lichen ruber acuminatus. Pityriasis rubra pilaris is a rare and progressive disease of the skin, characterized by the diffuse formation of scales and erythema (a hardening of the skin with persistent inflammation) of scalp, palms of the hands and soles of the feet. The characteristic primary lesion is a small, hard, dome-shaped, rose- or red-colored papula with a keratous central point traversed by a hair. The papulae end up by fusing together forming well-delimited, large, erythematous, orange-colored plates, among which islands of normal skin may be observed. The cause of the disease remains unknown, and a hypothesis has been raised that it may be related to a failure in the metabolism of vitamin A. Treatments more frequently used are oral or topical administration of retinoids and vitamin A. Most cases appear sporadically, but there are infantile cases suggesting a genetic cause. According to the International Classification of Diseases, organized by the World Health Organization - WHO, lichen planus and lichen acuminatus (pityriasis rubra pilaris) are distinct diseases, therefore classified under different groups.

(See Lichen; Lichen planus; Lichen ruber).

Sources: Cardenal, 1947; D'Elia, 1926; Stedman, 1979; www.21; www.22; www.23; www.24.

Lichen obtusus:a kind of lichen planus where papulae are more voluminous (instead of flattened) and less pruriginous. The purple-colored discs have a round or oval shape, measuring 1-2 cm in diameter and are generally situated on arms and thighs.

(See Lichen; Lichen planus).

Sources: Cardenal, 1947; Stedman, 1979; www.65; www.66.

Lichen planus: a dermatological infection characterized by the appearance of small, prominent spots on several parts of the body. The characteristic lesions are prominent, flat, violet-colored with white stripes on their surface, accompanied by much itching, in some cases exasperating. When the lesions recede they leave dark spots on the skin. Lichen planus may manifest itself under different forms, with the formation of ring-like, linear, verrucose (on the feet and ankles) or atrophic blistery lesions; erythematous lichen planus is liable of malignant evolution. In general, however, the disease is benign, with spontaneous remissions and exacerbations, typically persisting for one or two years, and it may follow a chronic or reincident course for a much longer time. It may be associated with minor symptoms or cause a considerable discomfort and incapacity. When the lesion reaches the entire tegument it is called generalized lichen planus. In the mucous membranes, which are affected in 50% of the cases, lesions are whitish and seem dead branches of a tree. In the mouth, the sensation is of ardency and burning. In about 10% of the cases of lichen planus, only mucous membranes are affected. The primary diagnostic is commonly made by a dentist from the observation of the buccal mucous membranes, where the initial symptoms appear. Although the etiology of the disease is unknown, numerous clinic observations have confirmed the fact that it occurs mainly in persons submitted to nervous tension, many debates having been raised about the theories postulating the self-immune and the psychological natures of lichen planus. The expression lichen ruber planus has been used to denote the color of the lesion, but it fell into disuse. In 1869, Erasmus Wilson gave the name lichen planus to the dermatosis that had probably been already described by Hebra as lichen ruber. At least two thirds of the cases occur in persons between 30 and 60 years old, being commoner in women. There is a great variety of topical and systemic therapies for lichen planus, options depending on the chronicity, symptomatology and variations of responses to the dermatosis. Relaxing bathes with oats, the application of creams, lotions or unguents of triancilone or betametasone, especially combined with corticoids, are considered beneficial. (See Lichen; Lichen ruber).

Sources: Houaiss, 2001; www.4; www.20.

Lichen ruber: term used in the 19th century, when Adolpho Lutz began his studies in dermatology, to designate what nowadays is called lichen planus. According to D'Elia (1926), there were two varieties of lichen ruber, lichen acuminatus and lichen planus, both pruriginous. The prognostic was severe and the affection tenacious and rebel to treatment, which consists in proper diet, the administration of arsenic preparations (Fowler's liquor, cacodilates) and the topical use of antiseptics and analgesics. (See Lichen; Lichen acuminatus; Lichen planus).

Sources: D'Elia, 1926; Stedman, 1979.

 

M

Mercury [Hg]: liquid and metallic chemical element, atomic weight 80, used to form compounds with medicinal purposes, to which were attributed, during Adolpho Lutz's times, antisyphilitic and antiseptic properties, in the latter case under the form 1-2% unguents. Mercury was also used as a component of cathartics, tooth pastes and anti-helminthic products; some mercurial compounds are still used today, albeit rarely. Mercury is, in addition, employed in thermometers, barometers, amalgams for dental fillings, for separating gold from auriferous sands, in fluorescent lamps, etc. Mercury, and its main source of extraction, cinnabar, have been known since the most remote times. The Chinese extracted it in Kwichan mines, since the year 1200 b.C. Phaenicians, 700 year before the Christian Era, used this metal to extract and purify gold. In India it was believed that mercury possessed aphrodisiac properties. The Incas utilized it as painting material, giving it the name llampi. Mercury was employed by the Egyptians since the 18th pharaonic dynasty (1600 b.C.), which was proved by the fact that the metal was found in a funerary urn from that period. Greeks and Romans used cinnabar in paintings and some of their most renowned physicians employed it under the form of unguents. Mercury designated the metal, the planet, and a god (the god of commerce and the messenger of the gods in Olympus); in order to avoid confusion, the Greeks called the metal hydrargyros, meaning quick-silver. The Latin form was hydrargyrium. It is from this word that its symbol, Hg, comes, as well as the terms hydrargyria, hydrargyrism, hydrargyrosis, now known as mercurialism, an intoxication provoked by the excessive absorption of the metal. Although it was known and used since Antiquity, up to the 15th century its use had been scarce, almost always restricted to the fabrication of inks and to medicine. Its growing consumption began when, in 1557, Bartolomé Medina, from Seville established a method for the cold amalgamation of silver minerals, by using that metal. In the 16 th century, Paracelsus introduced its use in the treatment of syphilis; Torricelli used it in the first barometer, in 1643; and in 1720 Fahrenheit used it in the confection of the thermometer. Mercury served for the analysis of gases in the works of Priestley, by the end of the 18th century. According to Wyngaarden (1992), nowadays over sixty professions are involved with the exposition to mercury: pesticides, insecticides and formicides manufacturing, fabrication of instruments containing, lamps, neon lamps, batteries, paper, inks, dyes, electric equipment and jewels, as well as materials used by dentists. Besides the industrial or occupational exposure to mercury, intoxication has also been the result of inadvertent contamination of cereals by pesticides containing the metal, as well as of accidental or intentional ingestion or injection of elementary mercury (or compounds based on this metal).

(See Syphilis).

Sources: Cardenal, 1960; Houaiss, 2001; Wyngaarden, 1992; www.77.

Metritis: term used in gynecology to designate a uterine inflammation, the types varying according to the affected part: cervical metritis (collum of the womb), corporeal metritis (body of the womb) and interstitial and parenchymatous metritis. The first one manifests itself by simple leucorrheas or small hemorrhages, demanding local treatment; the other mainly occur after childbirths or abortions. Metrites are efficiently treated by means of antibiotics. According to D'Elia (1926), they start at the mucous membrane and extend to the entire parenchyma of the organ; D'Elia divides its several forms into two groups: acute and chronic metrites; treatment is urgent in both cases. It is also called hysteritis or uteritis.

Sources: D'Elia, 1926; Larousse, 1971; Houaiss, 2001; Stedman, 1979.

Micrococcaceae: a family of bacteria of the Order Eubacteriales, whose representative genus is Micrococcus. It comprises Gram-positive, round-shaped species, generally motionless and aerobic, occurring alone, in pairs, in tetrads, agglomerates, irregular masses or even chains. It includes free-living, saprophytic, parasitic and pathogenic forms.

(See Micrococcus).

Sources: Houaiss, 2001; Littré & Gilbert, 1908; Stedman, 1979; www.160.

Micrococcus: designation common to the bacteria of the genus Micrococcus, which are Gram-positive and shaped like little coconuts. Aerobic, rarely motile, they are found in foods and used in the cure and production of some types of cheese. Adolpho Lutz and many other authors from the 19th century used the term "coccus" as synonym of micrococcus.

(See Bacteria).

Sources: Houaiss, 2001; Miquel & Cambier, 1902.

Microsporum: term of Greek origin meaning small seed. Microsporum belongs to dermatophytes, a heterogeneous group of fungi parasitic on the skin and hairs of men and several animals, living upon the keratin of the corneous layer, nails and hairs, and often provoking an inflammatory reaction of the skin, with pruritus, erythema, scales and vesicles (Wyngaarden, 1992). Besides Microsporum, Trichophyton and Epidermophyton also belong to the group of dermatophytes. Several species belonging to the genus Microsporum cause scalp tinea, a fungal infection that primarily affects the hairs of the body. This genus of fungus is more commonly found in children that have not yet reached puberty, when, generally, lesions disappear. M. audouinii is one of the causes of tinea, a disease transmitted from child to child through objects of personal use such as towels, bed clothes, hats etc. (Fitzpatrick, 1971). When scalp tinea is caused by M. canis, its agent may become fluorescent under Wood's lamp. But, for diagnosis purposes, exams of preparations with KOH and fungal cultures, using torn hairs and scales from the affected areas of the scalp are made (Wyngaarden, 1992). M. gypseum, commonly inhabiting soil, generates inflammation in cats and dogs, which, by their turn, transmit the disease to men (Fitzpatrick, 1971). Murray (1910) qualified Microsporum furfur as the fungus causing tinea versicolor, and M. minutissimum as the agent of erythrasthma, but Wyngaarden (1992) attributes the latter disease to Corinebacterium. (See Herpes tonsurans; Pityriasis circinata marginata).

Sources: Cardenal, 1947; Fitzpatrick, 1971; Murray, 1910; Wyngaarden, 1992.

Miliary tuberculosis: tuberculosis with generalized dissemination of the tuberculous bacillus and production of minute and countless small tubercles in several organs and tissues. (See Tuberculosis).

Sources: Cardenal, 1960; Stedman, 1979.

Mold: frequently found on the surface of organic matter, there proliferating fungi of the genera Mucor, Penicillium, Aspergilus, etc. (See Fungi).

Sources: Cardenal, 1960; Stedman, 1979.

Molluscum contagiosum: a chronic dermatological infection caused by the appearance of vesicles that transform into pustules. It is caused by a virus of the poxviruses family (Molluscipoxvirus molluscum contagiosum), normally occurring in children through contact with the skin of a contaminated person, most often attacking armpits, arms, neck and face. In adults, it mostly affects the genital region, being sexually transmitted. Its incidence is increasing within the immunodefficient population with Aids. The first clinical descriptions of the disease were produced in the beginning of the 19 th century by Thomas Bateman (1778-1821) and subsequently by Henderson and Paterson, in 1841. Only in 1905, Juliusberg, Wile and Kingery revealed the viral nature of molluscum contagiosum, which is also called cutaneous condyloma, contagious mollusk, epithelial mollusk and sessile mollusk. (See Condyloma).

Sources: Cardenal, 1954; Cardenal, 1960; D'Elia, 1926; Dorland, 1947; Stedman, 1979; www.83; www.96; www.107; www.119; www.139.

Morphine [C H NO ]: one of the most important alkaloids of 17 19 3

opium, used in medicine as analgesic, narcotic, sedative and anxiolithic. Morphine belongs to a group of substances derived from poppy (Papaver somniferum), from which opium is also extracted. Known for more than five thousand years, this plant was already used by Sumerians to fight against insomnia and intestinal constipation. The Greeks used opium in religious rituals and to give courage to warriors during battles. Galen and other physicians from the beginning of the Christian era prescribed the substance to victims of epilepsy, bronchitis, asthma, kidney stones, fever, melancholy, dysentery and other diseases. In the 19th century the use of opium spread along with the expansion of world commerce. In Great Britain, importation of the drug leaped from 40 tons in 1830 to 127 tons in 1860, of which 34 tons were re-exported to America. English businessmen transported opium from India to China, there exchanging it for tea and silk. Its use grew to such a point that, in 1838, the Chinese emperor Chung Ch'en forbade the importation of opium, condemning its users to the most severe penalties. The British Empire rose in defense of the traffic of the drug and obtained victory in the so-called Opium War (1839-1842), obliging China to hand over the island of Hong Kong, to liberate the importation of opium and to pay indemnities for the cargoes confiscated during the conflict. In 1900, about half the adult male population of China was opium addicted, a calamity that only ended in 1949, with the victory of the revolution that led Mao Tse Tung to power. In the beginning of the 19th century, the main active substance of opium, morphine, was extracted. Its name derives from Morpheus, the Greek god of sleep. Certain sources attribute this innovation to Armand Seguin, a physician of the Napoleon army; others to Friederich Sertuener, a pharmacist from Hannover, dates varying between 1803 and 1806. Other medical innovation, the syringe with hypodermic needle, created by the French physician Charles Gabriel Pravaz in the 1850's, facilitated the introduction of this and other drugs in human organism. Morphine then began to compete with opium in medicine and toxicomania. It continued to be used to give physical and psychological relief to persons recruited for wars, generating the so-called "soldiers disease", responsible for thousands of addicted men. In the passage from the 19th th to the 20 century, morphine was so disseminated that even in cafeterias and theaters of large cities it was common to see men and women injecting the "remedy of gods" into themselves. Addiction became a severe social and sanitary problem and led to a program of studies to obtain a medication with the same therapeutic value, but without involving dependence. Bayer thought it had found that substance in 1874, through the work of the same pharmacist who had developed aspirin, Heinrich Dreser: diacetylmorphine, better known as heroin, from the German heroisch, for its "heroic" capacity of subjugating evils. The supposed antidote, largely used in the treatment of tuberculosis and other diseases, soon became another poison to dispute the preference of addicts to opium and morphine. Later on, other poppy alkaloids were discovered, such as codeine and thebaine. During World War II, the scarcity of morphine led a German laboratory to the discovery of methadon, afterwards used in the treatment of heroine addicts. In 1942, the United States Congress declared illegal the importation of this latter drug, and in the following decades its production and use in medicine were banished in almost all countries of the world. Opiates such as morphine possess a chemical structure capable of bonding themselves to neurotransmitters called endorphines, which are associated to the control of pain, sensations of pleasure, well-being and relaxation. Reaching the brains, those drugs depress the nervous centers responsible for pain and vigil, and the regions controlling respiration, heart beats and blood pressure. They interfere in the so-called pain-threshold, regulating the interpretation of pain signals received by the brains, without neutralizing other sensations, thus explaining its popular use as anesthetics. As the human organism becomes dependent upon the drug, the situation is inverted, and the user comes to use it for disturbances caused by abstinence: nausea, vomits, diarrhea, muscular cramps, intestinal colics, lachrymation etc. The unregulated organism stops producing some substances and begins to produce too much of other ones. Addicts are subjected to more severe damages: deafness, blindness, inflammation of the heart valves, vein necrosis, coma and death. Presented as insoluble crystals with bitter taste, when morphine is combined with acids, it produces soluble salts with a content equivalent to 10% of its weight. Its action upon the central nervous system is manifested by a brief period of excitation followed by depression, the stimulation varying according to the type of drug and dosage. Morphine is used as analgesic in the treatment of violent pains (spasms of the smooth musculature or pains of cankerous patients, for instance (but its action upon the organism abates with time and dosages must be increased). It is injected in the form of hydrochlorides or sulfates and serves for the preparation of numerous derivatives (diamorphine, codeine, codetiline, heroin, metopon). The specific antidote to neutralize the effects of morphine is N-allylnormorphine or nalorphine.

Sources: Ferreira, 1999; Larousse, 1971; Houaiss, 2001; Koogan-Houaiss, 2004; Stedman, 1979; www.45; www.41; www.10.

Mus decumanus (Pallas, 1778): a junior synonym of Rattus norvegicus, the Norway, brown or common rat.

Sources: Wilson & Reeder, 1993.

Mushroom: the relatively large fructifying body of fungi belonging to the Class Basidiomycetes; filamentous fungi provided with septate hyphae and sexually reproduced through basidiospores. These pluricellular fungi, devoid of chlorophyll, consist of two parts: one under the ground, living upon buried matter that affords its food, and the other above the ground, called fructifying body or basidiocarp, producing cells called basidiospores, from which new beings are developed. The hat, commonly called mushroom, is in reality the stalk or stem which germinates from the mycelium. (See Fungi; Schizomycetes; Hypha).

Sources: Houaiss, 2001; Silveira, 1981.

Mycobacterium leprae: the microorganism causative of leprosy, described by the Norwegian doctor Gerhard Armauer Hansen (1841-1912) in 1874. Also called Hansen's bacillus, it is an aerobic, alcohol and acid resistant bacterium in the shape of a straight, or slightly curved rod, sometimes ramified. The genus Mycobacterium was proposed by Karl B. Lehmann and R. O. Neumann in 1896, for the agents of leprosy and tuberculosis. Up to now, it has not been possible to cultivate Hansen's bacillus in artificial media, what partially explains the controversies about the mode of transmission of leprosy.

(See Bacteria; Leprosy).

Sources: Benchimol & Sá, 2003; Bier, 1957; Encyclopædia Britannica, 2001; Larousse, 1971; Houaiss, 2001.

Mycosis: a disease caused by fungi, affecting plants and animals. Among the numerous species of the Kingdom Fungi, some develop in human tissues, causing greater or lesser lesions. Those having particular tropism for keratin, a fibrous protein that constitutes hairs, nails and the corneous layer of epidermis, proliferate there, determining dermo-epidermic reactions. These, called ceratophytes by some authors together with dermatophiles, are the agents of superficial mycoses and only involve the skin and its annexes: scalp and groins tinea and tinea versicolor, for instance. The mycoaerophilous or anaerobic fungi, by their turn, find living conditions in dermis and hypodermis, in cavities and internal organs, originating deep or systemic mycoses. Mostly contracted through inhaling, they spread through lympho-hematogenic ways, reaching organs such as lungs, skin, liver and central nervous system. To this group belong blastomycosis, coccidioidomycosis, cryptococcosis and histoplasmosis. The classical division of mycoses into "superficial" and "profound" is didactic, but cannot be rigorous, as affections produced by yeasts, predominantly superficial, sometimes determine systemic lesions. Querion and dermatophilic sycosis are examples of superficial mycoses with intense dermo-hypodermic involvement. On the other hand, profound mycoses may show secondary manifestations in their initial stages or evolution. The agents of those mycoses are then reached by topical fungistatics or fungicides, with relative facility. Classic topicals still used nowadays are iodized alcohol at 1%, sulphur and its derivatives (sulphites, sodium hyposulphite), benzoic acid and its derivatives; mercurials and dyes, especially aqueous gentian violet at 12%. Keratolithics (such as salicylic acid at 2-5%) favor the action of topicals. More modern active substances are propionic and undecilenic acids and their salts, hexylresorcinol, tribromohydroxytoluene, chloroiodinehydroxyquinaldine, bromosalicycilchloroanilide, haloprogin, chlotrimazol, myconazol, tolnaftate and tolcyclate. Nystatin and amphotericin B, in solution, suspension, gel cream or ointment, are topical antibiotics largely employed. As vaginal pills, ovules or creams, nystatin, amphotericin B and piramycin are useful in the treatment of vulvo-vaginites. Systemic medicaments are employed in profound mycoses and cavity mycoses, as well as in resistant and extended, dermo-hypodermic, follicular and ungueal dermatophytoses. Potassium iodide, sodium iodide, sulfas, sulfones, calciferol, thiabendazole, clofazimine and 5-fluorocytosine, as well as the antibiotics griseofulvin, nystatin, amphotericin B, erythromycin, tetracychlines, chloromycetin and others (Veronesi, 1982). As a rule, mycoses are not transmitted from person to person. The natural habitat of several pathogenic fungi is limited to specific geographical areas. Consequently, the population living in those areas is more susceptible of contracting such "endemic mycoses". Some fungi are opportunistic pathogens, liable for causing diseases when the defenses of the host are altered. Cultures of fungi and histopathological studies made from infected body liquids (sputum, blood, urine and liquor) and tissues (skin, lungs, liver, bone marrow and lymph nodes) are the main methods for the diagnostic of mycoses. Their dissemination has increased with the growing use of antibiotics, which kill bacteria that destroy fungi. The terms fungal diseases and mycoses are synonyms. Sources: Houaiss, 2001; Koogan-Houaiss, 2004; Veronesi, 1982; Wyngaarden, 1992.

Myxomycetes: a group of unicellular, generally free-living microorganisms, similar to fungi and extremely primitive. They are normally found on stumps and the bark of trees, decomposing wood and moist soil. They reproduce by means of spores disseminated by the wind, which, upon germinating, originate filamentous structures of proteic nature called flagella, responsible for the locomotion of the microorganism. Later on, the flagella detach from the myxomycetes and unite into a gelatinous mass provided with slow, amoeboid movements. Next, these myxamoebae, united two by two, form a zygote (a cell formed from the fusion of masculine and feminine gametes), which may unite with other zygotes to form a multinucleate protoplasmic mass without cellular wall, called plasmodium. The plasmodium multiplies, originating a great number of spores of varied shapes, frequently found on the above indicated environments. The myxomycetes have a very complex taxonomic history. As they present characters in common with fungi and protozoans, they were already classified by biologists in one group or the other. They are now included in the Kingdom Protista. (See Fungi).

Sources: Cardenal, 1960; Dorland, 1947; Nosso Século, 2002; Encyclopædia Britannica, 2001; Ferreira, 1999; Houaiss, 2001; Koogan-Houaiss, 2004; Landouzy & Jayle, 1902; Stedman, 1979; www.170; www.171; www.172.

Mange: See Scabies.

Matterstock, Georg: German doctor who was born in Würzburg on February 12, 1847, and who died in that same city on May 30, 1915. He was Privat-Dozent (1878) and ausserordentlich Professor (extraordinary professor) at the Faculty of Medicine of the University of Würzburg (1888), having directed the polyclinic of that institution.

Sources: www.143.

N

Neisser, Albert Ludwig Siegmund: German dermatologist Born in Schwidnith, Prussia (now Swidnica, Poland) on January 22, 1855. Graduated in Breslau (1877), Neisser is mostly known by his bacteriological studies, especially the discovery of the etiological agent of gonorrhea (Neisseia gonorrhaeae) in 1879. Among his professional realizations, are yet to be mentioned the description of the microorganism of leprosy (1879-1880), a motive of disputes with Norwegian doctor Gerhard Armauer Hansen, and the attempts to discover the etiological agent of syphilis and its possible transmission to man by animals. He worked with August Paul von Wassermann (1866-1925) and Carl Bruck (1879-) on the development of a test of serum-reaction for syphilis, later on known as Wassermann's reaction. In the field of public health he was an active fighter for improvements of prophylactic measures and more public education about venereal diseases. Professor of dermatology at the University of Leipzig in 1880, he was named Privat-Dozent of that same institution the following year. In 1882 he assumed the post of ausserordentlicher Professor (extraordinary professor) of skin and venereal diseases at the Faculty of Medicine of Breslau, where he also was made head of the Department of Dermatology. Ten years later he inaugurated in that city a clinic that became internationally known as a center of research on skin diseases. He died in July 1916, in Breslau, Prussia (now Wroclaw, Poland).

Sources: Larousse, 1971; www.227.

Neoplasm: abnormal tissue growing through cellular proliferation more rapidly than the normal, even after the stimulus that started the process has ceased. Neoplasms are distinct masses of tissue presenting a partial or complete lack of structural organization and functional coordination with the normal tissue. The term "tumor", literally meaning "inflammation", is frequently used as synonym of neoplasm. It may be benign or malignant and is observed in all the tissues: there are fibrous, lymphatic, vascular, cartilaginous, bony, muscular, nervous and epithelial neoplasm. The probability of its occurrence increases with age and is higher in women than in men; womb, stomach and breast are more affected than other parts of the body.

Sources: D'Elia, 1926; Stedman, 1979.

Nodose erithema: acute inflammation of the subcutaneous tissue preferentially attacking the lower limbs. Characterized by the presence of painful, deep and soft nodules originated from the exudation of blood and serum, almost always accompanied by ardency and intense itching. The disease was described for the first time in 1808 by the English dermatologist Robert Willan (1757-1812). In 1860, Ferdinand von Hebra (1816-1880) established its specificity, separating it from the lesions included in the group the multiform erithema. Also known as tuberculous erithema or rheumatic peliosis.

Sources: Cardenal, 1947; Ferreira, 1999; Fitzpatrick, 1971; Larousse, 1971; Houaiss, 2001; Murray, 1910; Stedman, 1979; www.169; www.211.

North American blastomycosis: caused by the fungus Blastomyces dermatidis, it is characterized by suppurated tumors of the skin (cutaneous form) or by lesions of lungs, bones, subcutaneous tissue, liver, spleen and kidneys (systemic form). Found in mean, dogs and other animals, it is not transmissible from person to person. Blastomyces spores probably invade the organism through the respiratory tract, when inhaled. The disease starts gradually, with fever, chills and profuse sweating. The individual may show productive cough, chest pains and breathing difficulties. The disease is treated with fungicidal antibiotics (amphothericin B), showing results within a week, the fungus rapidly disappearing. If untreated, the infection slowly worsens and leads to death. It is common in the United States, but very rare in South America. It was described by Thomas Gilchrist in 1894, and for this reason the disease is also known as Gilchrist's disease or mycosis.

(See Blastomycetes).

Sources: Larousse, 1971; www.30; www.34; www.58.

Nostocaceae: a family of Cyanophyceae ("blue algae"), characterized by more or less spherical cells united into non-ramified threads, which, when mature, produce heterocysts, either terminal or intercalary, and acynetes. Many species produce mucilage, forming gelatinous masses on humid soil or on water. The term used to have much broader meaning, but it came to be identified with the Order Hormogoneae, in which it is now included.

Sources: Ferreira, 1999; Houaiss, 2001; Joly, 1977; Quer, 1965; www.173.

 

O

Oidium or oidia: Obsolete name for certain fungi with Oidiomycetes characteristics, whose hyphal separation results in the formation of rectangular arthrospores (a type of thallospores). Nowadays it is known as the genus Candida. (See Hypha; Oïdium albicans).

Sources: Fortes, 1958?; Jackson, 1920/1935?; Stedman, 1979.

Oidium albicans: Obsolete name of Candida albicans or Monilia albicans. Candida is a very large genus of yeast-shaped fungi, frequently found in nature. It is generally a saprophytic fungus, but may become pathogenic, causing the infection called candidiasis or moniliasis, resulted from the alteration in the equilibrium of bacterial flora of the organism or after the ingestion of certain antibiotics. It attacks mainly the region of the mouth, oropharynx, vagina and gastrointestinal tract.

Sources: Fortes, 1958?; Houaiss, 2001; Jackson, 1920/1935?; Stedman, 1979.

Oidium lactis: Obsolete name of a species of fungi very much used in the fermentation of milk for the preparation of several types of cheese. It is characterized by whitish spots exhaling a typical odor of mold. Nowadays known as Geotrichum candidum, this species may cause lesions in human digestive and pulmonary tracts.

Sources: Dorland, 1947; Fortes, 1958?; Jackson, 1920/1935?; Stedman, 1979; www.50; www.120.

Ophüls, William: Born in 1871, Ophüls was professor of pathology and Dean of Stanford School of Medicine from 1916 to the date of his death, on April 27, 1933.

Sources: www.90.

Orthopnea: respiratory difficulty that obliges the patient to keep standing or sitting in order to breathe. It is generally related to pulmonary diseases causing valvular pneumothorax and pleuropulmonary congestion, but may also follow from heart problems such as pericarditis.

Sources: Cardenal, 1960; Paulier, 1882.

 

P

Papula: a small, solid elevation formed on the skin, without pus or serosity, which dries out soon after it started. Generally pinkish, papula is constituted by the infiltration of the superficial or papillary layer of dermis; it disappears through desquamation, without leaving scars.

Sources: D'Elia, 1926; Houaiss, 2001.

Papulous eczema: dermatitis caused by the eruption of isolated or aggregated red papulae, with intense itching.

Sources: Cardenal, 1960; Stedman, 1979.

Pellagra: a term whose original meaning was "rough skin"; it designates a disease also known as endemic erythema, Lombardian, Italian or Asturian leprosy, Italic elephantiasis, Saint Ignatius itching, maidism, rose disease or maidic psychoneurosis. An infirmity caused by the appearance of pruriginous erythematous spots on the face, neck and hands, spots covered by blisters that dry out and peel off. These cutaneous manifestations are associated with digestive disturbances (red tongue, aphthous stomatitis, signals of gastritis, diarrhea, constipation), as well as mental disturbances that may evolve to madness. Formerly very common, nowadays it is rare, mostly occurring in poor regions. It is now known that pellagra is caused by a shortage of nyacin and vitamin PP. Such substances are found in fresh meat, yeast and in many other proteic foods. Individuals feeding mostly on corn and its derivatives have a shortage of nyacin and tryptophane, thus being predisposed to suffering pellagra. Known since Antiquity, the disease was described by the first time in 1735 by Gasper Cajal, but only in 1912 Casimir Funk related pellagra, as well as beriberi and scurvy, to alimentary deficiency. According to D'Elia (1926), in the beginning of the 20th century, at least two theories about the etiology of pellagra disputed primacy: one attributing the disease to the excessive ingestion of corn and the other considering the action of a still unknown parasite. The obnoxious influence of corn continued to be maintained by many authors in the 1920's; unhealthy housing, excessive labor and heredity were also considered factors that predisposed to the disease. In 1920, North American doctor Joseph Goldberger (1874-1929) demonstrated that pellagra had a nutritional origin and was not a parasitic infection or disease. During a trip to southern United States, Goldberger observed people in asylums, hospitals and orphanages in order to verify how they acquired the disease. He verified that the absence of tryptophane in the alimentary diet of the patients caused the disease and suggested the ingestion of milk and eggs as a preventive measure. In 1926 Goldbeger discovered the anti-pellagra factor in many other foods. Later studies have shown that corn is poor in tryptophane, pyridoxine and riboflavin, which explains why pellagra decimated populations whose alimentation was mainly based on that grain. Following the model defined by Goldberger, now the disease is treated by including proteic foods in the patient's diet and avoiding starch foods, especially those derived from corn. Sources: Cardenal, 1947; Dorland, 1947; Larousse, 1971; Koogan-Houaiss, 2004; Murray, 1910; Stedman, 1979; www.43; www.44.

Pemphigus: designation common to a potentially deadly group of dermatoses due to an unknown cause, characterized by the appearance of blistery eruptions over the skin, which, when absorbed, leave fragmented pigmented spots. Cutaneous lesions in the shape of blisters have been described since the Antiquity, but the term pemphigus was only employed in 1760 by the French doctor and botanist Boissier de Sauvages de la Croix (17061767). The disease described by Sauvages was probably a case of multiform erythema, as there was continuous high fever and it lasted for approximately two weeks. The concept he gave was of a blistery eruption of short duration. Sauvages' definition was accepted by the contemporary medical circle up to 1791, when Johann Ernst Wichmann (1740-1802) gave to pemphigus its modern meaning, i. e. of a chronic blistery disease; for eruptions with a short duration he suggested the name febris bullosa. Wichmann was the first to describe a proved case of vulgar pemphigus. In the ensuing years, the concept underwent many alterations, many times almost undifferentiated from those formulated for other vesicular lesion. In 1860, Ferdinand von Hebra (1816-1880) denied that pemphigus could manifest itself in acute form and again established Wichmann's definition, which lasts up to now. In the pemphigus-group different clinical manifestations are included, standing out the vulgar, the foliaceous and the vegetative forms.