Glossary

(See Foliaceous pemphigus).

Sources: Cardenal, 1960; D'Elia, 1926; Ferreira, 1999; Larousse, 1971; Houaiss, 2001; Landouzy & Jayle, 1902; Murray, 1910; Stedman, 1979; www.184; www.185; www.186; www.187; www.188.

Peptone: a water soluble substance derived from animal and vegetable proteins (meat, milk, soybean, etc.), obtained during gastric and pancreatic digestive process. Often used for cultivating bacteria.

Sources: Cardenal, 1947; Dorland, 1947; Houaiss, 2001; Stedman, 1979; www.105; www.128.

Periadenitis: the inflammation of tissues near a gland, mainly observed as a complication of adenitis (inflammation of the lymphatic ganglia or of a gland). (See Adenitis).

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

Phenacetin or Acetophenetidine [C H O NO ]: acetic amide 10 13 2 2 used as analgesic, anti-pyretic and anti-rheumatic. Indicated for combating typhoid fever, flue, pneumonia, tuberculosis, rheumatism and diverse types of neuralgias. It must be carefully administered, as it has a highly toxic effect upon the kidneys.

Sources: Cardenal, 1960; Houaiss, 2001; www.125.

Pyrogallic acid [C H (OH) ]: the same as pyrogallol; a substance 6 3 3

obtained from gallic acid. It has multiple chemical and medical applications as anti-pruriginous and, externally, in the treatment of psoriasis, microsporic scurf and other cutaneous affections.

Sources: Houaiss, 2001; Stedman, 1979.

Pityriasis: generic designation of dermatoses characterized by erythema and fine desquamation. In the beginning of the 19 th century Robert Willan and other founders of dermatology employed the term to designate a heterogeneous group of skin diseases whose common denominator was the occurrence of small dry scales. Afterwards, slight forms of dermatites came to be designated as pityriasis rosea or Gibert's pityriasis, pityriasis rubra pilaris; lichenoid, pityriasis versicolor (later on called tinea versicolor) and pityriasis nigra (name given by Hebra to chronic pediculosis). In D'Elia (1926), pityriasis is defined as the dermatosis caused, in several parts of the body, by parasites of the family Pediculidae (Order Anoplura), among them included human lice. (See Pityriasis circinata marginata; Vesicular pityriasis).

Sources: D'Elia, 1926; Houaiss, 2001; Murray, 1910.

Pityriasis circinata marginata: also known as pityriasis rosea, pityriasis maculosa, pityriasis maculata or Filbert's pityriasis rosea. Medical literature from the last two centuries registered reports of disorders apparently identical to that described by French dermatologist Camille-Melchior Gibert (1797-1866) as pityriasis rosea in his Traité Pratique des Maladies de la Peau et de la Syphilis, 1860. Other names were given to this disease by Pierre-François-Olive Rayer (1793-1867): erythema annulatum; Ferdinand Ritter von Hebra (18161880): herpes tonsurans maculosus et squamosus; Erasmus Wilson (18091884): lichen annulatus serpiginosus; Horand: pityriasis circinata; Alfred Hardy (1811-1893): disseminated pityriasis; Jean-Baptiste-Emile Vidal (1825-1893): pityriasis circinata and marginata; Pierre-Antoine-Ernest Bazin (1807-1878): pityriasis rubra and acute disseminated pityriasis; Ernest Henri Besnier (1831-1909): erythrodesquamative pseudexanthema; Robert Willan (1757- 1812): roseola annulata; Behrend: roseola furfuracea herpetiformis; Nicolas and Chapard: roseola squamosa. The disease is characterzed by papulas and scaly plates, oval or rounded, of a bronzy-rose or salmon color, that rapidly appear on the trunk, neck, arms and legs, rarely on the face. Several aspects of this self-limited, papulo-scaly affection are unique: first, the generalized eruption is frequently preceded, by a few days or a week, by a single larger lesion, called "forerunner spot" ("mother plate" or "master plate"), often erroneously identified as dermatophytosis. The master plate, present in 50 to 90% of the cases, may appear on any place, but generally occurs on the neck or the lower part of the trunk, reaching a diameter of a few centimeters. The second singular characteristic: the oval lesions possess white scales, uncommonly slender, forming a small collar near the plate's borders. Thirdly, the lesions follow the cleavage lines of the skin, forming a pattern comparable to a Christmas tree. The affection has a spontaneous involution within one to two months. Pruritus may be a marked symptom. Sometimes pityriasis rosea is preceded by a slight infection of upper respiratory areas and its greater incidence is in the winter months, suggesting a viral etiology. However, the disease does not occur in endemic form and is not transmitted interpersonally. Most cases attack children and young adults 10 to 35 years old. Occurrences are rare. Treatment for pityriasis rosea is generally unnecessary, although topical corticosteroids and anti-histaminics may alleviate the erythema. Ultraviolet light frequently reduces the eruption. Cardenal (1947) attributed the cause of the disease to a fungus of the genus Microsporum; Staphylococcus albus. Spirochetes have also been incriminated, whereas other authors have suggested a possible viral cause, a hypothesis still being studied (Freedberg, 1999). Up to now the etiological agent of the disease has not been isolated. Pityriasis rosea is considered a cutaneous affection of unknown origin. (See Pityriasis; Vesicular pityriasis).

Sources: Anais de Dermatologia, 1998; Cardenal, 1947; Fitzpatrick, 1971; Freedberg, 1999; Houaiss, 2001; Stedman, 1979; Wyngaarden, 1992.

Pleurisy: acute or chronic inflammation of the pleura, generally from bacterial origin. It appears in most cases as a consequence of pneumonia, tuberculosis or other infectious diseases. In pleurisy, both surfaces of the pleura become dry and rough, causing friction. The so-called dry pleurisy provokes intense pain that worsens with cough and a deeper inhaling. In pleurisy with blood-shed, the lung is compressed by the accumulation of liquid flowing from the blood vessels towards the pleural cavity. It is normally accompanied by chills, fever, cough and dyspnaea.

Sources: D'Elia, 1926; Ferreira, 1999; Larousse, 1971; Houaiss, 2001; Koogan-Houaiss, 2004.

Pneumonia: acute or chronic inflammation of the lungs, potentially fatal and contagious, caused by bacteria, viruses or fungi, but it may also be of allergic nature or due to irritation by chemical substances. Its characteristic symptoms are chills, pain in the chest, cough, catarrh, high fever and breathing difficulties. It more frequently attacks aging patients and children below five years old. The disease may appear suddenly, following other infirmities, or after a surgery. The several types of pneumonia are defined according to their localization and the extension of the lesion of the pulmonary tissue. From the anatomical point of view, they may be classified as lumbar, segmentary, lobular and interstitial. When lobular pneumonia affects both lungs it is frequently called bronchopneumonia. A bacterial etiology of pneumonia was supported by Edwin Klebs (1834-1913), in 1875. Six years later, Louis Pasteur (1822-1895) identified the bacterium Pneumococcus in the saliva of a patient attacked with rabies. The association of the pneumococcus, or Diplococcus pneumoniae, with lobular pneumonia was established in 1883 by Charles Talamon (1850-1929). Three years afterwards, Albert Fraenkel (1848-1916) and Anton Weichseelbaum (1845-1920) confirmed and extended Talamon's investigations, observing the behavior of pneumococcus in culture media and its pathogenic action upon rabbits. During that time the idea that pneumonia was a typically bacterial disease prevailed, with well defined evolution and clinical features. However, studies undertaken from 1930 on revealed the existence of singular cases, whose clinical evolution differed from the established pattern. Moreover, in those cases the presence of bacteria could not be demonstrated. In 1944, Monroe D. Eaton isolated a filterable agent capable of producing pneumonia in rats and hamsters. In the beginning, it was believed to be a virus and the name pleuropulmonary-like organism - PPLO was given to it. Later on, Robert N. Chanock classified it as an intermediary agent between virus and bacterium, belonging to the genus Mycoplasma, species pneumoniae. (See Croupous pneumonia).

Sources: D'Elia, 1926; Ferreira, 1999; Koogan-Houaiss, 2004; Stedman, 1979; Veronesi, 1982; www.189.

Pneumotyphus: typhoid fever beginning with pneumonia, which evolves by itself when pneumonia is about to end. (See Pneumonia).

Sources: D'Elia, 1926.

Posadas, Alejandro: parasitologist, born in Buenos Aires, Argentina, on December 22, 1870. Since he was very young, Posadas suffered from pulmonary and rheumatic ailments that compelled him to abandon his college studies thrice. Entering the Faculty of Medicine in 1888, he studied under pathologist Robert Johan Wernicke's (1854-1922) orientation. In the University Hospital, in 1891, he had the opportunity to examine a soldier, Domingo Ezcurra, who had recurrent cutaneous nodular lesions diagnosed as fungoid mycosis. In the material extracted from the neoplasmas, Posadas observed the presence of spherical organisms with a thick wall, containing small rounded formations. Because of these characteristics, he identified the microorganism as a sporozoan, the same conclusion Wernicke had reached. Posadas published his discovery in the paper "Un nuevo caso de micosis fungoidea con psorospermia" in the journal Círculo Médico Argentino (1892; 15: 585-97). The term psorospermia was a reference to organisms known at that time as coccids. Also in 1892 Wernicke published in Germany "Ueber einer Protozoenbefund bei Mycosis fungoides", in Centralblatt für Bakteriologie und Parasitologie (1892; 12: 858-61). Posadas was able to reproduce the disease in laboratory animals, thus proving the presence of the parasite. He was not able, however, to cultivate it. The correct identification of the microorganism, Coccidioides immitis, included in the group Ascomycetes fungi, would be established by Ophüls and Moffit in 1900. Graduating in 1894 with honors and distinction, in the same year Posadas defended his thesis "Psorospermiosis infectante generalizada", (afterwards called Posadas' disease or coccidioidomycosis). He accompanied the evolution of the disease in the Argentinian soldier up to the latter's death in 1897, the necropsy revealing extended visceral lesions. Having traveled to Europe in search of solace for his pulmonary disease, Posadas died in Paris on November 21st, 1902, at only 32 years of age. During his eight-year career, he had other remarkable achievements as a docent, clinician and researcher. He was the first to film a surgical intervention at Hospital de Clínicas in Buenos Aires and, together with Wernicke, was the first to report a case of rhinosporidiosis.

(See Coccidioidomycosis; Coccidium; Psorospermosis; Wernicke, Robert Johan).

Sources: www.39; www.40; www.205; www.206; www.207.

Potassium iodide (KI): a white salt, crystallized into cubes, very soluble in water and alcohol, that melts when exposed to heat. It results from the decomposition of iron iodide by potassium carbonate, or the heating of iodine with potassium or sodium carbonate. Up to the advent of antibiotics, in the 1930's, when it was substituted by penicillin, potassium iodide was largely employed in the treatment of tertiary syphilis. In the 19th century it was also employed in the therapy of lymphatic tuberculosis and asthma, among other applications. Nowadays it is employed as expectorant and fungicide, being administered in potions, solutions or syrups. It is also utilized in the fabrication of paper and photography revealers. (See Iodine; Syphilis).

Sources: Lello, 1942; Littré & Gilbert, 1908; Paulier, 1882; www.147; www.148.

Pseudotuberculosis: a set of diseases of rodents, birds, ovines and other warm-blooded animals, clinically and anatomically similar to tuberculosis. It is characterized by the formation of granulomas looking like tubercular nodules, due to a coccoid bacillus, in the case of Guinea pigs, or to a diphtheroid bacillus, in the case of mice and mutton. Pseudotuberculosis occurs in men as a result of a very rare infection caused by Pasteurella pseudotuberculosis. (See Tuberculosis).

Sources: Houaiss, 2001; Stedman, 1979.

Psoriasis: a recurrent, non-contagious chronic dermatosis characterized by the eruption of reddish plates covered with white or silvery scales. The lesions show well delimited and varied sizes, from discrete and localized forms to severe forms that may cover the entire body surface. They appear especially on the knees, scalp and trunk. A typically human affection, it equally attacks men and women of any age. Clinical manifestations are varied. According to their localization and to the characteristics of the lesions, they are classified as vulgar, palmo-plantar, arthropathic, erythrodermic, and other less important forms. Vulgar psoriasis, responsible for 90% of the cases, is the best known of them. Typical form of the disease, it is rarely pruriginous and may also attack nails. In the palmo-plantar modality, lesions are located on the sole of the feet and on the palms of the hands. The skin becomes hard, dry and frequently presents crackings. Arthropathic psoriasis appears suddenly, causing pain in the tips of fingers and toes and in the large joints. In some cases, it may affect the joints. The erythrodermic form shows generalized lesions over almost all the body. Confounded during a long time with leprosy, psoriasis was described for the first time by Robert Willan (1757-1812) in his On cutaneous diseases (1808). The cause of the disease is still unknown, but it is admitted that it is related to some genetic predisposition and to factors such as cutaneous traumas (Koebner's phenomenon), infections, use of medications and emotional stress. Although no treatment may lead to permanent cure, lesions disappear or show a sensible regression when treated. Therapy depends upon the patient's clinical condition. In less severe cases hydration of the skin and exposure to the sun are recommended, combined with the topical use of creams and unguents based on cortisone, vitamin D, coaltar and antraline. In severe cases systemic or orally administered medications are prescribed. More recently laser therapy has been used. Psoriasis is also known as psora or alfos, terms of Greek origin meaning, respectively, "mange" and "white".

(See Leprosy).

Sources: D'Elia, 1926; Koogan-Houaiss, 2004; Stedman, 1979; Wyngaarden, 1992; www.212; www.213; www.214; www.215; www.216.

Psorosperms: according to Murray (1910), certain unicellular organisms belonging to the group protozoans of the Order Myxosporidia were thus called. The following properties characterize them: they multiply by fission and each one of the organisms thus generated is surrounded by a firm layer forming a spore that remains enveloped in a capsule or cyst; each spore may again divide into small bodies that, finally, develop into larger mature individuals. It was considered that the complete developmental cycle of these organisms was not limited to man (in which it would cause psorospermosis), but also parasitized other hosts. In more recent dictionaries, psorosperm is defined as a minute parasite, generally the young form of gregarines, an order of protozoans that parasitize animals such as earthworms, lobsters etc. (See Psorospermosis).

Sources: Cardenal, 1960; Murray, 1910.

Psorospermosis: morbid state due to psorosperms. According to Murray (1910), the term was used to name human lesions caused by certain forms of protozans (Sporozoa) e by Coccidium that affect also the bile ducts of rabbits. Darier's disease (keratosis follicularis), Paget's disease (a rare form of breast cancer), certain carcinomas and molluscum contagiosum, diseases now known to have very different etiologies, have been described as caused by psorosperms. According to the same source, infection in man could attack all the viscera in rare cases, or only the liver, the urinary tract, or the skin, on which nodular or vesicular lesions spread. When infection was generalized, the patient's condition was compared to trichinosis. Symptoms included pains in the limbs, vomit, headache, delirium, somnolence and fever. Death generally occurred in the period of fifteen days to a month, the patient undergoing a "typhoid phase". There was not, then, any treatment for the infection and diagnosis could only be made by discovering the typical cysts and the parasites. Coccidioidomycosis, a disease caused by fungi of the species Coccidioides immitis, also known as Posadas' disease, was originally described by this Argentinian doctor in 1892, as "nuevo caso de micosis fungoidea con psorospermia", this last term alluding to the similarity of the forms found in that mycosis with protozoans ("coccids"). In Dorland (1947), psorospermosis is defined as a morbid state due to the presence of those myxosporidian microorganisms. In more recent medical dictionaries this condition is no longer described. Darier's disease, a rare and hereditary disease of the skin, still has as a synonym follicular psorospermosis, but without any relation with the etiology, which is still unknown (microscopic studies suggests a defect of synthesis, organization or maturation of the complex that controlls normal keratinization). (See Psorosperms).

Sources: Cardenal, 1960; Dorland, 1947; Houaiss, 2001; Murray, 1910; Stedman, 1979.

Pulmonary emphysema: a disease characterized by the permanent increase of the aerial spaces localized beyond terminal bronchioles, either by dilatation or by destruction of alveolar walls. The lesion of the small aerial sacs, through whose walls oxygen penetrates the blood and carbonic gas is liberated, makes some patients present bluish skin, as the oxygen rate in the blood becomes less than normal. Emphysema may inhibit up to half the functional capacity of the lungs before the patient perceives that something is seriously altered in his organism. Most times the disease begins with a pulmonary infection called chronic bronchitis, and is discovered through a radiographic exam of the thorax, to see the state of the heart or of the lungs. The patient finds exhaling specially difficult. Other symptoms are frequent flues, cough, excess of mucus in the throat, indigestion and short breath. The disease mostly affects people of the masculine gender, 40 years old or more. Emphysema causes the loss of elasticity of the pulmonary tissue and the permanence, in the lungs, after each respiration, of residues of carbon dioxide that intoxicates the organism, robbing space from inhaled oxygen; the heart has to work more, so that a sufficient quantity of oxygen may be incorporated to the blood, generating, in many cases, a cardiac affection capable of leading the patient to death. The number of affected people among smokers is thirteen times as great as among non-smokers. Air pollution also has its influence, epidemics of emphysema having been registered in London and in industrial valleys in Belgium and Pennsylvania in the United States. Heredity may also be an etiological factor, and we now know that about one fourth of the patients show the lack of an enzyme called alpha-antitripsin, which protects the lungs against infections. Emphysema has no cure, but those who start treatment as soon as it begins have long and reasonably active lives. The medical resources available for emphysema are medicaments, hormones, pumps for introducing oxygen under pressure in the lungs and, and in extreme situations, lung surgery. According to D'Elia (1926), one of the most active remedies used at that time to attenuate breathing difficulty was potassium iodide (0:50 by 1, per day) associated or not to arsenic.

Sources: D'Elia, 1926; Ferreira, 1999; Houaiss, 2001; Koogan-Houaiss, 2004.

Pyrogallic acid [C H (OH) ]: the same as pyrogallol; a substance 6 3 3

obtained from gallic acid. It has multiple chemical and medical applications as anti-pruriginous and, externally, in the treatment of psoriasis, microsporic scurf and other cutaneous affections.

Sources: Houaiss, 2001; Stedman, 1979.

 

Q

Quebracho: popular Portuguese name for several native plants of South America, belonging to different genera and families, whose hard and resistant wood presents high concentration of tannin, a substance much employed in the tanning of hides. In Brazil, the term is applied to diverse plants of the genera Schinopsis and Aspidosperma. The name "quebracho", also employed as synonym of "quebracho-vermelho", comes from the Spanish and means ax-breaker, an allusion to the hardness of its wood. (See Aspidosperma; Quebrachocolorado).

Sources: Ferreira, 1999; Larousse, 1971; Houaiss, 2001; Koogan-Houaiss, 2004; Stedman, 1979; www.163.

Quebracho-colorado: the same as "quebracho-vermelho". Name common to several trees of the genus Schinopsis, family Anacardiaceae, whose main characteristics are the bark rich in tannin and the reddish, hard bark. The species S. lorenzii, found in Brazil, Paraguay, Argentina and Uruguay, is a tree about 20 meters heigh, with reddish-brown bark, elliptical leaves, very ramified panicle and ligneous samarae. (See Quebracho).

Sources: Ferreira, 1999; Larousse, 1971; Houaiss, 2001; Koogan-Houaiss, 2004; Stedman, 1979; www.163.

Quincke, Heinrich Irenaeus: German medical doctor born in Frankfurt an der Oder on August 26, 1842. His family then moved to Berlin, where his father made a brilliant career as a clinical doctor. Heinrich Quincke studied medicine in Würzburg, Heidelberg and Berlin, with famous teachers such as Albert von Kölliker (1817-1905), Hermann Helmholtz (1821-1894) and Rudolf Virchow (1821-1902). In the latter city he obtained his MD in 1863 and, two years later, went to Vienna to work under the physiologist Ernst Wilhelm Ritter von Brücke (1819-1892). Quincke was the assistant of many other important scientists and soon came to occupy the chair of general clinic at Berne (1870). From 1874 on, he dedicated himself to surgical interventions in lungs. Four years afterwards, he assumed the chair of general clinic at Kiel, where he remained for three years, until retiring as Emeritus Professor of that discipline. He then went to Frankfurt am Main, and continued lecturing as honorary professor, dying in that city on May 19, 1922. He had a very important role in the research of tuberculosis, creating techniques of drainage of the pulmonary abscess to allow patients' expectoration. He also investigated the mechanisms controlling body temperature, developing a theory about the central nucleus, responsible for the warming of the entire organism. His greatest contribution to medicine, however, was the pioneer use of the lumbar region puncture for the diagnostics and treatment of pulmonary diseases. He also made important observations on the expansion of the hepatic artery (1870). (See Quincke's aedema).

Sources: Landouzy & Jayle, 1902; Stedman, 1979; www.108; www.132; www.141.

Quincke's aedema (or disease, or syndrome): a cutaneous infirmity developed in sporadic or hereditary form, attacking both sexes. It begins with the sudden appearance of pain and swelling in the facial region, feet and genital organs, persisting for two or three days, when it finally disappears. It may also cause strong abdominal pains and even fatal respiratory complications. Marcello Donati was the first to describe this kind of aedema, in 1586, but only during the 19 th century the edematous urticaria, as the disease is also known, was studied by the British surgeon and dermatologist John Laws Milton (1820-1898). In 1882 Heinrich Irenaeus Quincke also described it; twelve years later it was studied by Henry Martyn Bannister (1844-1920).

(See Quincke, Heinrich Irenaeus).

Sources: Landouzy & Jayle, 1902; Stedman, 1979; www.132; www.141.

Quinine or "quinine salt" [C H N O ]: alkaloyd composite in the 20 24 2 2 form of white, inodorous powder with bitter taste, extracted from bushes of the genus Cinchona, used as a stomachic and oxytocic agent, as analgesic, antipyretic, flavoring of tonic water, for muscular relaxation, to combat atrial fibrillation and in the treatment of malaria. It has proved very efficient against the forms of impaludism caused by Plasmodium ovale or Plasmodium vivax. Quinine is also employed in brain malaria, in malaria produced by chloroquine-resistant strains of Plasmodium falciparum and in crises of malignant tertian malaria. Cardenal (1960) presents a somewhat different formula of it (C H N O +3H O) from the consulted sources, adding 20 24 2 2 2 that the substance is used in the form of salts - bromhydrate, chlorhydrate, phosphate, salicyllate, sulphate, etc. Those salts, according to the same source, either incite the nervous system and render the pulse slower, when administered in small doses, or provoke cerebral congestion, deafness and dizziness when taken in higher dosages. The substance was already known by the Incas at the time of the conquest of the Americas by the Spanish Crown, and it is known that the Jesuits were the first to describe the prophylactic properties of the bark of the Cinchona tree, used by Peruvian aborigines in the most varied febrile manifestations. In 1820, the French chemists Joseph-Bienaimé Caventou (1795-1877) and Pierre-Joseph Pelletier (1788-1842) were able to isolate the active principle of quinine, allowing the large scale industrial production of the chemical, an object of great disputes during World War II.

Resistance to the components of this substance led to the adoption of substitutes such as chloroquine and primacrin in malarial treatment.

Sources: Cardenal, 1960; Dorland, 1947; Houaiss, 2001; Stedman, 1979; www.85.

 

R

Rhinoscleroma: a chronic granulomatose process attacking the nose (the starting point of the infection), upper lip and upper respiratory areas. It generally starts with the growth of hard and smooth nodules, painful when pressed, that spread towards the pharynx, larynx, and bronchi, and may even involve the external acoustic meatus. Surprisingly, the sense of smell remains intact. Skin becomes pale, anemic, or dark-violet, and rich in superficial vascular nets, deprived of hairs and follicles. It is believed that rhinescloma is due to a specific bacillus, possibly a strain of Klebsiella rhinoscleromatis, described by Viennese surgeon Anton von Frisch (1848-1917). According to D'Elia (1926), therapy was surgical and symptomatic and the results only temporary, as the affection constantly presented relapses. Nowadays streptomycin is successfully used in the treatment of the disease.

Fonte: Cardenal, 1947; D'Elia, 1926; Houaiss, 2001; Stedman, 1979.

Rixford, Emmet: Canadian surgeon born in Quebec in 1865, died in the United States in 1938. He graduated at Cooper Medical College, in San Francisco in 1891, becoming associate professor of that institution in 1893; five years later, he was promoted to full professor. In 1909 he became professor of surgery at Stanford University. Rixford was one of the first physicians to observe a case of coccidioidomycosis. As a homage to this fact, his name was given to a mountain in Sierra Nevada. (See Coccidioidomycosis).

Fonte: www.52.

 

S

Saccardo, Píer Andrea: Italian mycologist, born in Treviso in 1845 and died in Padua in 1920. He obtained his MD in 1867 from Padua University, of which he became professor of natural history two years afterward. In 1879 he changed to lecturing botany and assumed the direction of the botanical garden of that university. His major contribution to mycology was the publication of the atlas Sylloge fungorum omnium husque cognitorum (1882-1913), a collective work in 11 volumes, containing descriptions and illustrations of all the fungi known until then.

Sources: Larousse, 1971; www.209; www.210.

Saccharomyces: a genus of Ascomycetes, fungi or yeasts belonging to the family Saccharomycetaceae, whose type is beer yeast (Saccharomyces cerevisiae). Similar yeasts are used in the production of other alcoholic drinks and bread. Saccharomyces possesses a predominantly unicellular stem, reproduces asexually by budding, transverse division or both, produces ascospores, but is devoid of myceliar filaments. One member of this genus, S. neoformans (ancient name of Cryptococcus neoformans) was isolated from the fermented juice of peaches by Italian microbiologist Francesco Sanfelice in 1894; soon afterwards, it was verified that it was the agent of human cryptococcosis. Certain sources cite saccharomycosis as synonym of blastomycosis, as the fungi of the genus Saccharomyces figure among the agents of this group of infirmities. (See Cryptococcosis; Cryptococcus neoformans; Fungus).

Sources: Cardenal, 1960; Stedman, 1979.

Saccharomyces albicans: a fungus formerly placed in the genus Saccharomyces, now known as Candida albicans (Monilia albicans), parasitic on animals, found in several parts of the human body, especially in the gastrointestinal tract, the oropharynx and other muco-cutaneous regions. The bacteria living in the intestine normally prevent the proliferation of the fungus. However, if the equilibrium is disturbed by antibiotics or any disease, the fungus develops and produces an affection called mugget, candidiasis or moniliasis, characterized by white plates that spread inside the mouth, the vagina and sometimes the anus. (See Oïdium albicans).

Sources: Cardenal, 1960; D'Elia, 1926; Stedman, 1979.

Salicylic acid [HOC H COOH]: acid used in medicine, in 6 4

pharmaceutic industry and the industry of dyes. It is used topically as ceratolythic (descaling), antiseptic and fungicide. According to Murray (1910), this acid was also used as anti-pyretic.

Sources: Houaiss, 2001; Stedman, 1979.

Salol [C H O ]: a substance resulting from the mixture of salicylic 13 10 3

acid with phenol, employed as analgesic, anti-rheumatic and anti-pyretic. It was used as an antiseptic in chronic wounds (under the form of aromatized powder) and in the treatment of gonorrhea, a bacterial infection transmitted by sexual relations. According to D'Elia (1926), the expression "salol proof" designated the method of gastric function by means of an injection of one gram of salol and subsequent investigation of salicylic acid in the urine: if the stomach did not contract much and the pancreas functioned normally, it would appear in the urine the reaction produced by the salicylic acid which, on the other hand, did not react to the bad pancreatic activity. Also called phenol salicylic ester and phenyl salicyllate.

Sources: Cardenal, 1960; D'Elia, 1926; Dorland, 1947; Houaiss, 2001; Landouzy & Jayle, 1902; Stedman, 1979; www.134; www.135.

Scabies or Mange: known in Brazil as coruba or curuba, já-começa, jareré, jereré, pereba, pira or sarna. A contagious cutaneous disease affecting man and other animals, caused in the latter by several kinds of mites and in the former by Sarcoptes scabiei. It is transmitted by direct contact with the infected skin, during sexual relations or the common use of clothes. The male parasite opens cavities in the skin and there the female lays her eggs, which eclode within seven to ten days afterwards, generating new parasites. Scabies occurs in men and women of whatever age and is not always associated with bad hygienic conditions. It manifests itself through intense itching, papulae, vesicles and wounds, which may spread over the abdominal region, arms, genitals and legs. In animals it infects abdomen, legs, breast and ears, and may cause the definitive or temporary loss of hairs (alopecia). Treatment is made orally and through topical applications, the isolation of the patient being recommended. Moreover, all clothes must be substituted daily, including bath and bed clothes. There exists one type of itch, the "Norwegian itch", whose degree of infection is very high and whose symptoms are more severe than usual, with intense scaling. It is estimated that every year about 300 million cases of scabies appear in the world; its pathogenic agent has been known for at least 2,500 years.

Sources: Houaiss, 2001; www.84; www.91; www.95; www.97; www.98; www.136; www.157.

Scarlet fever: an infecto-contagious pathology, characterized by the appearance of a reddish or scarlet erythema (hence the origin of the name), of enanthema of the mucous membranes, principally on the internal side of cheeks and pharynx, besides high fever and generalized descaling. It is caused by Streptococcus scarlatinae, a beta-hemolytic streptococcus of the A group. The disease may appear at any age, but it affects principally children and requires therapeutic intervention, nowadays on the basis of antibiotics. Its clinical picture involves a four day incubation period, angina and pyrexia by the end of 24-48 hours, cutaneous eruptions around the neck and loins; descaling of the skin between the seventh and eighth days, the surging of plaques along several weeks and alteration of the mouth's mucous membrane. In more serious cases, the abscesses last for a longer time, and sometimes it is accompanied by rheumatism, otitis and nephritis. Cardenal (1960) classifies the disease into: "ambulatory", a benign form, with no fever; "anginous", indicated by the exasperation of pharyngeal symptoms; "apyretic", with benign evolution of the initial symptoms and a slightly feverish state; "hemorrhagic", with blood elimination in the skin or urine; "latent", with absence of cutaneous eruption, but evolution of pharyngeal angina and nephropathy; "malignant", in which the severest symptoms are intensified, producing great physical weakness; "nervous", form in which convulsions and cerebral symptoms predominate; and, finally, "papulous", with the appearance of papulae. Scarlet fever epidemics have been known since Antiquity, having been described by Hippocrates in the 5th century b.C., and by Cornelius Celsius in the first century of our era. Up to 1676, when Thomas Sydenham (1624-1689) established definitively the distinctive characteristics of the infirmity, it was considered as a variety of measles or smallpox. It streptococcic origin was identified by Friedrich Loeffler (1852-1915) and confirmed by Klein in 1886. In 1923, North-American microbiologists Gladys Rowena Dick (1881-1963) and George Frederick Dick (1881-1967), in collaboration with Alphonse Dochez (1882-1964), evinced the specific etiology of the disease when they experimentally reproduced it in humans.

Sources: Cardenal, 1954; Cardenal, 1960; D'Elia, 1926; Larousse, 1971; Houaiss, 2001; Schreiber & Mathys, 1991; Stedman, 1979; www.99; www.100; www.101; www.121; www.5.

Schenck, Benjamin R.: North-American surgeon (1873-1920) born in Syracuse, New York. Graduated in 1898 at John Hopkins Medical School, he dedicated himself to the practice of gynecology in Detroit, from 1903 on. He was a gynecologist of Harper Hospital and associate professor of the State Medical Society in 1906, a position occupied up to 1919, when health problems forced him to move to California, where he died, victim of tuberculosis. We owe him the discovery of Schenck's disease, a gummatous lymphangitic form of sporotrichosis. (See Sporotrichosis).

Sources: Stedman, 1979; www.12.

Schizomycetes: name used in ancient systems of classification to designate a division of the Vegetable Kingdom encompassing all the bacteria. In 1857, for instance, Carl von Nägeli, a botanist from Munich, united several genera of bacteria in a group called by him Schizomycetes, placing it next to colorless primitive plants, i. e. mushrooms. In botany, bacteria is a synonym of Schizomycetes. Under this denomination were included the unicellular plants devoid of chlorophyll, reproducing by simple division, such as bacteria and blue algae (Cyanophyceae). In the 19 th century the term was the subject of debate, in the wider controversy on the nature of bacteria. (See Bacteria; Fungi; Mushroom).

Sources: Benchimol, 1999; Houaiss, 2001; Stedman, 1979; www.31.

Schrön, Otto Carl Gottlieb von: German doctor born in Hof, Bavaria, on September 7, 1837. He studied medicine at the Universities of Erlangen and Munich and in 1864, after obtaining the doctorate, was invited by Professor De Filippi, from Turin, to come to Italy to make the preparates and drawings of anatomy that had rendered him famous. One year later he became professor of pathological anatomy at Naples University, and in this city he died on May 13, 1917. Schrön has his name associated to an acid-resistant bacillus found in the egg germinative spot (Schrön's granule).

Sources: Cardenal, 1960; Dorland, 1947; www.228; www.166; www.42.

Scleroma, sclerema or scleroderm: a small, hardened and circumscribed area occurring especially in the tissues of the nose and larynx, but also in other regions of the skin and the mucous membranes.

Sources: Cardenal, 1960; Houaiss, 2001; Stedman, 1979.

Silver nitrate [AgNO ]: in medicine it has been used in the 3

treatment of epilepsy, chorea, tabes and dysentery. In more or less diluted solutions, it was applied externally in cases of blenorrhagia, of simple, granulose or purulent conjunctivitis and yet as a caustic and antiseptic substance. Internally, it was applied in cases of chest angina, hemiplegia, diabetes, affections of the digestive tract (gastritis, dyspepsia, gasltralgy, cholera), including expulsion of worms.

Sources: Cardenal, 1960; Paulier, 1882.

Simple Pneumonia: pneumonia affecting only one of the lungs. (See Pneumonia).

Sources: D'Elia, 1926.

Sodium salycillate: salycillate is an ester or salt originating from salycilic acid (amonium, bismuth, mercury, etc.) found in aspirin or other medicines used to combat pain and fever, as well as anti-acids, anti-diarrhoetics and solutions for the removal of corns or warts. Excessive doses of sodium salycillate, above 200 to 500 mg, may cause collapses, convulsions, diminution of the respiratory capacity and of blood pressure, several neurological disturbances, nausea, gastrointestinal bleeding, somnolence, vomit, ear buzzing and other symptoms. Treatment must especially fall upon the attenuation or elimination of the acid effect of the salycillate upon the organism.

Sources: Cardenal, 1960; Houaiss, 2001; www.157.

Soft chancre: also known as chancroid, simple venereal cancer, Ducrey's ulcer, soft ulcer, simple venereal ulcer, or, popularly, in Brazil, as "cavalo" (horse). It is a typically human, acute infection, sexually transmitted, caused by Haemophilus ducreyi, a Gram-negative coccobacillus, with rounded ends, of difficult growth in culture media (even under ideal conditions, only 65% of them have the expected growth). It was only in 1900 that Fernand Bezançon was able to cultivate this microorganism in media composed of gelose and rabbit blood. The etiology of soft chancre was the subject of intense disputes up to the second half of the 19th century. While some authors maintained its identity with syphilitic chancre, others affirmed that they were dealing with a new pathology, originated by a proper germ.

The specific characteristics of the disease were established by Léon Bassereau (1810-1887) in his Traité des affections de la peau symptomatiques de la syphilis (Treatise of the symptomatic affections of syphilis in the skin), and by Phillippe Ricord (18001889), in his "Lettres sur la syphilis" (addressed to the chief editor of the Union Médicale), both published in Paris in 1852. In 1889, the Italian doctor Augusto Ducrey (1860-1940) isolated the causative agent of the soft chancre and was able to reproduce in man the typical ulceration and all the stages of the infirmity. In that same year, Ducrey's experiment was reproduced in monkeys by Charles Nicolle (1866-1936). The existence of the bacillus was also corroborated by Primo Ferrari and Mannino De Luca, in 1889, and by Paul Gerson Unna (1850-1929), in 1892. The disease attacks especially external genitalia, but may also compromise anus and, more rarely, lips, mouth, tongue and throat. Characterized by ulceration accompanied by infectious adenitis and ganglionar abscess, this affection is clearly dominant in the male gender, but also occurs in women. Contagious by inoculation, it is disseminated by the pus generated at the infected place. From four to five days after coition, an inflammatory papula appears, evolving, after two or three days, to a very painful typical ulceration, which may be multiple, but in most cases simple. Although there is an association between soft chancre and syphilis in about 10% of genital ulcers, in the case of soft chancre, ulcers appear under a non-hardened (soft) consistency, with well-defined, upright, reddened rim, over a dirty, purulent ground with fetid odor. Differently from syphilitic ulcer, chancroid does not cicatrize spontaneously. There is no serological test available for testing it; diagnosis is made clinically, through the identification of the characteristic ulcer that appears soon after the suspect sexual contact. With the early use of antibiotics there occurs no progression of adenopathy, but in untreated cases it may evolve into suppuration and fistulization through a single orifice. The first medicines used, already in the era of antibiotics, were sulfas and then tetracyclins. The cost of treatment is high, because it uses expensive medicaments, rendering it difficult in poor countries like Brazil. The use of erythromycin, furnished by the public health service, is a good option for all cases of the disease. Due to its nature, sexual partners must be treated together. Vaccines against soft chancre are being developed. Considered as the main sexually transmissible disease before the advent of antibiotics, it continues to be the commonest genital ulcer in developing countries. After the introduction of sulfonamides there has been a steep decrease of its incidence, but registered cases tended to increase in certain countries by the end of the 1960's. The disease remains endemic in many regions where social and economic conditions are precarious, prostitution having an important role in its dissemination.

(See Chancroid; Syphilis).

Sources: Bier, 1957; Brouardel & Gilbert, 1896; Cardenal, 1960; Dorland, 1947; Houaiss, 2001; Murray, 1910; Stedman, 1979; Veronesi, 1982; Wyngaarden, 1992; www.78; www.79; www.80; www.175.

Sommer, Baldomero: Argentinian doctor born in Buenos Aires on March 21, 1857, died in the same city on April 18, 1918. The son of a German mother and Danish father (a famous hat maker in that city), Sommer obtained his doctorate in 1874 and strived to increase the knowledge, prevention and cure of hanseniasis. Hospital Baldomero Sommer, one of the most important Argentinian hospitals dedicated to the treatment of that disease, bears his name by a Decree from July 11, 1947. The Argentinian physician was the secretary of the First International Conference on Leprosy, held in Berlin in 1897. He participated in the Latin-American Scientific Congress held in Montevideo the following year, writing down the deliberations concerning leprosy. He was also honorary president and promoter of the First National Conference on Leprosy in Buenos Aires, in 1906. Three years later, he was the representative of the Argentinian Government in the Second International Conference on Leprosy, in Bergen. Sommer is considered one of the main creators of the "Argentinian dermatological, leprological and syphilographic school"; around 1892, he created and directed that chair in the Faculty of Medical Sciences at Buenos Aires. In 1907 he founded the Argentinian Society of Dermatology, the first institution of that kind in Latin America. He would also participate as foreign or corresponding member in the dermatological societies of Paris, Berlin, Rome and Rio de Janeiro. He was also head of the service of skin diseases of Hospital de Niños, founded in Buenos Aires on April 30, 1875. In 1892 he occupied the same position in Hospital San Roque, now Ramos Mejía. Sommer presided the Argentinian Medical Society in 1897 and in 1912 entered the National Academy of Medicine, of which he was general-secretary in 1918. Public health was another field in which he played an important role. He was "Director de Asistencia Pública" in Buenos Aires and a vocal of the National Department of Hygiene. In the middle of 1910 he was counselor of the municipality. Baldomero Sommer presented a project regarding the pasteurization and obligatory treatment of the milk destined to the inhabitants of the federal capital, a project transformed into law in December 1907. He also took part in the campaign against mosquitoes that began in 1913. (See Leprosy).

Sources: www.13; www.9; www.8; www.266.

South American blastomycosis: caused by the fungus Paracoccidioides brasiliensis, it is also known as Lutz's disease or Lutz-Splendore-Almeida's disease. The inflammatory process is localized in the submucose and presents itself as a non-specific chronic infiltrate, revealing microabscesses and granulomes of the giant epithelioid cells. It reaches the trachea and the lymphonodus. Very often lesions of the oral mucose, larynx and pharynx occur. Cutaneous lesions result from the haemotogenic dissemination of the fungus and are generally related to an infectious process of higher gravity. These lesions, with a polymorph aspect, appear in the face and around the body's natural orifices such as mouth, nose and anus. Antibiotics, associated with rest, hyperproteic and hypercaloric diet with vitamin supplementation, are important for its treatment, although a total "cure" is still unavailable for bearers of paracoccidioidomycosis, due to the impossibility of eradication of its causative agent. The different therapeutic modalities only decrease the quantity of fungi in the organism, allowing the recovery of cellular immunity and the reestablishment of equilibrium between parasite and host. Paracoccidioidomycosis is an autochtonous systemic mycosis of Latin America. Of an endemic character among populations of rural zones, it attacks mostly individuals of the male gender, 30 to 60 years old, its incidence being rare in persons below the age of 14. It is important to public health for its incidence in an economically active population and for frequently causing severe consequences preventing individuals of reassuming work. If untreated, it generally leads to obit. For many years the concept that the infection occurred by the implantation of the fungus in the oral mucosa through traumas caused by the habit of chewing different types of vegetables prevailed. Nowadays, the inhaling way is considered the main entrance door of the infection. In 1908, Adolpho Lutz published observations that inaugurated the studies of South American blastomycosis, also known as Brazilian blastomycosis or paracoccidioidomycosis. In that paper, Lutz already separated this disease from the one described by Posadas and Wernicke - the coccidioidomycosis. (See Coccidioidomicose).

Sources: www.3; www.33; www.56.

Spina or spina ventosa: bone lesion eventually observed during tuberculosis or osseous cancer, in which the affected bone dilates in greater or lesser degree, as if inflated by gas.

Sources: D'Elia, 1926; Dorland, 1947; Landouzy & Jayle, 1902; Stedman, 1961; Stedman, 1979.

Spirochaeta pertenuis: microorganism originally named and described by Aldo Castellani in "On the presence of spirochaetes in some cases of parangi (yaws, Framboesia tropica). Preliminary note", Journal of the Ceylon Branch of the British Medical Association, 1905. Through several experiments, Castellani proved that monkeys could be infected with material extracted from persons suffering of yaws, especially their blood. He also demonstrated that, when they were removed by filtration, the material became harmless. Lastly, Castellani showed that it was possible to detect antigens and antibodies specific of yaws by means of the Bordet-Gengou reaction. The bacteria received other names, such as Spirochaeta pertenuis, given in 1912 by Lehman and Neumann. Gross, also in 1912, placed that species in the genus Spironema, and Macé, in 1913, in the genus Spirillum. It is now known as Treponema pertenue. It is the causative agent of piã, a term of the Tupi (Brazilian indigenous) language meaning "raised skin, tumor". Patients attacked by this disease (also called framboesia tropica) respond positively to Wasserman's test. Treponema is a genus of anaerobic bacteria (Order Spirochaetales) consisting of cells 3 to 8 microns in length, with sharp, regular or irregular spires, without an obvious protoplasmic structure. They are difficultly stained, except with Giemsa's dye or silver impregnation. Some species are pathogenic and parasite man and other animals, generally producing local lesions in the tissues. (See Yaws).

Sources: Cardenal, 1960; Stedman, 1979; www.61; www.62.

Splendore, Alfonso: Italo-Brazilian doctor (Cocenza, Italy, 1871; Sâo Paulo, 1953). Graduated at the Faculty of Medicine of Rome (1897), he worked as an assistant to Angelo Celli in the Institute of Hygiene of that capital. In Brazil, Splendore worked with Adoplho Lutz at Instituto Bacteriológico of São Paulo. When he returned to Italy to serve in his country's army during World War I (1914-1918), he had already published several important contributions, among them Toxoplasma cuniculi (1910), a pioneer work on human toxoplasmosis; Blastomicose, esporotricose e relações com processos afins, a communication submitted to the VII Congress of Dermatology and Syphilography held in Rme (1911); Toxoplasmose de coelhos, presented at the I Congress of Comparative Pathology (1912); Una afezzione micótica com localizazione nella mucosa della bocca, osservata in Brasile, determinata per fungi (Zymonema brasiliense sp.), published in the Bulletin de la Société de pathologie exotique (1912, 5: 313-319), one of the foundation stones of the discovery of South American blastomycosis, also called LutzSplendore-Almeida's disease. (See South American Blastomycosis).

Sources: Larousse, 1971; Stedman, 1979.

Spore: reproducing corpuscle of fungi and of certain species of bacteria. Generally of a unicellular and mononucleate structure, spores are devoid of embryos, possessing the capacity of germinating under certain conditions and of reproducing asexually. Resistant to heat and dessication, they either develop by themselves or after fusion with other spores.

Sources: Houaiss, 2001; Ferreira, 1999; Landouzy & Jayle, 1902; Littré & Gilbert, 1908.

Sporotrichosis: a generally benign infection of men and animals caused by fungi of the species Sporothrix schenckii, often limited to the skin and the subcutaneous tissue, which may spread to the bones and internal organs, especially in immune-deficient individuals. Three forms have been described: a disseminated gummatous form (Beurmann's disease), a gummatous lymphagitis (Schenck's disease) and an haematogenous form characterized by the presence of multiple abscesses. Distributed worldwide, sporotrichosis especially attacks farmers, horticulturists and other field workers, as Sporothrix is commonly found in rose-trees, gooseberry's bushes, sphagnum moss and other vegetable matters. The fungus penetrates the body through injuries in the skin of the extremities of the body or the gastrointestinal tract. The initial cutaneous lesion is characteristic: a subcutaneous nodule of elastic consistency, spherical shape and mobile. Once attached to the skin, it becomes reddish and then black, due to the tissue's necrosis or death. In the following days or weeks, the cutaneous infection spreads through the lymphatic vessels of the hand and arm up to the lymph nodes, forming nodules and ulcers along their course, and may reach the lungs and other tissues. According to D'Elia (1962), the disease began to be studied in the beginning of the 20th century; it was then considered that its agent was a fungus which could live for a long time as saprophytic upon plants, which thus became transmission agents. At that time treatment consisted of internal use of potassium or sodium iodide in high doses (3-5 grams a day), or, in cases of intolerance, in subcutaneous injections of iodated preparations, such as iodated oil, iodone, iodine-gelatin, etc. This treatment was assisted by bitters, by gastric antisepsy and the application of iodated dressings over the ulcerated gummas. Nowadays the infection is treated with oral intraconazol; potassium iodate is also administered, although not so efficacious and capable of causing collateral effects in most patients.