Glossary

(See Beurmann, Charles Lucien de; Schenck, Benjamin R).

Sources: D'Elia, 1926; Houaiss, 2001; Stedman, 1979; www.34; www.58.

Sporotrichum: a genus of the Fungi Imperfecti, similar to yeast fungi, which formerly included Sporotrichum schenckii, the causative agent of sporotrichosis in men and animals. Only some species of this genus are pathogenic, such as S. schenckii, S. beurmanni, S. dori, which are also agents of sporotrichosis.

(See Sporotrichosis).

Sources: Cardenal, 1960; Stedman, 1979.

Staphylococcus: a Gram-positive, round-shaped bacterium generally forming irregular agglomerates of cocci similar to bunches of grapes. Potentially pathogenic, these bacteria are motionless, aerobic or anaerobic, and do not develop spores. They may provoke local suppurative lesions, alimentary poisoning and severe opportunistic infections. They are found in skin, cutaneous glands, nasal mucous membranes and in food products. (See Bacteria).

Sources: Ferreira, 1999; Houaiss, 2001; Landouzy & Jayle, 1902; Littré & Gilbert, 1908; Stedman, 1979.

Staining: a stage of the technique for microscopic section preparation, consisting of imbibing them in dyes which fix on certain elements, rendering their observation easier. For animal tissues, the substances used are haematoxylin, eosin and methyleneblue, iodated water, etc.; in bacteriology, especially ammoniacal fuchsine is used (Gram's method), which divides the bacteria into Gram-positive and Gram-negative, depending on the fixation of the dye. (See Fuchsin; Gram's method).

Sources: Larousse, 1971.

Stenosis: congenital or acquired state in which the light, passage or caliber of a natural or organic conduct, as, for instance, the urethra or the heart valves, is much narrower. The expression "diphtheric stenosis" probably designated this anomaly observed in the larynx, trachea or larger bronchi.

Sources: Larousse, 1971; Houaiss, 2001; Stedman, 1979.

Streptococcus: common denomination of bacteria occurring in groups of small spheres associated in the shape of chains. They are aerobic or facultatively anaerobic, Gram-positive, almost always motionless, and they do not form spores. Generally parasitic upon vertebrates, they are especially localized in mouth, upper air passages and intestines of human beings and other animals. The type-species is Streptococcus pyogenes, ethiologic agent of various infectious diseases, described by Anton Rosenbach (18421923), in 1884. Other species pathologic to man are S. pneumoniae (Klein, 1884; Chester, 1901), causing pneumonia, and S. aureus (Rosenbach, 1884), agent of endocarditis and meningitis. Some non-pathogenic species, such as S. lactis (Lister, 1873; Lohnis, 1909) and S. cremoris (Orla-Jensen, 1919) are used in the fabrication of butter and other dairy products.

(See Bacteria).

Sources: Ferreira, 1999; Houaiss, 2001; Landouzy & Jayle, 1902; Littré & Gilbert, 1908; Stedman, 1979; www.168.

Strychnine [C H N O ]: substance isolated by the French 21 22 2 2

chemists Joseph Bienaimé Caventou (1795-1877) and Pierre Joseph Pelletier (1788-1842) in 1818. It is extracted from the bark and especially from the seeds of plants of the genus Strychnos, whose more dangerous species are Strychnos nuxvomica, Strychnos colubrina, Strychnos minor and Strychnos toxifera. According to Stedman (1979), strychnine is an alkaloid from Strychnos nuxvomica, presented in the form of colorless crystals of intensely bitter flavor, almost insoluble in water. Having as main characteristic the capacity of stimulating the central nervous system, strychnine is used as stomachic, antidote for depressive toxics and in the treatment of miocarditis. Its therapeutic popularity, however, is undesirable, as it is capable of producing acute or chronic poisoning in men and animals. It is used inclusively to kill rodents. By the end of the 19th century, Paulier (1882) recommended administration of small doses of strychnine as pills, hypodermic injections, unguents, syrups, powder, alcoholic tincture and extract, for gastric problems (dyspepsia, gastric trouble, constipation), affections of the nervous system (asthenic paralysis, hemiplegia, paraplegia), cholera, pellagra, intermittent fevers and other diseases.

Sources: Ferreira, 1999; Houaiss, 2001; Paulier, 1882; Stedman, 1979.

Sublimated carbol (C H OH): a colorless crystallized compound 2 5

obtained by the distillation of coal pitch. Through the addition of 10% water, it becomes a clear liquid with peculiar odor and pungent taste. It is a powerful germicide, but very toxic. In a 2.5% solution it was used externally in the treatment of wounds and ulcers, and internally in cases of diphtheria and fetid bronchitis. It is also employed, in 5% solutions, as an environmental disinfectant and for disinfecting surgical instruments and the hands of surgeons. In pure state it is caustic and local anesthetics. It was also used as unguent (at 10%).

Sources: Cardenal, 1960.

Syphilis: an infectious disease of chronic and systemic character, generally transmitted by sexual contact and rarely by feto-placentary contamination (congenital syphilis). It is caused by Treponema pallidum, a spirochete attacking man exclusively. For a long time it was confused with gonorrhea and other treponematoses. In 1838 it was individualized by the French dermatologist Philippe Ricord (18001899), who classified the clinical evolution of the disease into three distinct periods: primary, secondary and tertiary. In the primary phase, after an incubation period of two to three weeks, a superficial wound appears. In a few days, it evolves towards a resistant and almost painless ulceration called hard chancre, protosyphiloma or primary chancre. The lesion is well delimited, with smooth and uniform surface. It generally occurs on the genital region, being very contagious and almost always accompanied by inflammation of the lymphatic ganglia. It recedes spontaneously within three to five weeks, before or after the beginning of the second phase of the disease. In the secondary period, the dissemination of the infirmity through the blood stream occurs, causing the appearance of lesions on the mucous membranes and of cutaneo-maculose eruptions (syphilitic roseolas) that may extend over the entire body. Lesions appear in about two months after infection. They may be accompanied by high fever, anemia, generalized adenopathy, and pain in articulations. They also recede spontaneously with the increase of immunity. The so-called tertiary syphilis corresponds to the third and last stage of the disease. It is characterized by tegumentary lesion beginning with the appearance of soft nodosities (syphilitic gums) disseminated all over the body, which evolve towards ulceration, causing damage to the viscera and the cardiovascular apparatus. In some cases the central nervous system is affected, with the occurrence of dorsal tabes, progressive paralysis of limbs or syphilitic meningitis. More rarely, there is the occurrence of extrategumentary lesions, including several affections of eyes and bones. Tertiary syphilis manifests itself between the third and the fifth year after infection, in untreated cases. In this phase, the possibilities of transmission are extremely reduced. The geographical origin of syphilis is a much debated question. Some historians consider that it was introduced in Europe by Spanish sailors coming back from the American continent in 1493. Others, on the other hand, maintain that this infirmity would originate in the European continent itself, but that for a long time it remained confounded with leprosy. Anyway, it may be said that the existence of syphilis in Europe was only widely recognized after the epidemics that assailed the continent at the end of the 15th century. The uncertainties about the origin of syphilis are manifest in the several denominations this malady received, associating it to different countries (America, Portugal, Naples, France, Germany, Scotland, among others). The word «syphilis» was invented by the Italian physician and poet, Girolamo Fracastoro (1478-1553), in his poem Syphilis, sive morbus gallicus, narrating the history of a fictitious shepard, Syphilus, chastised by the gods with this terrible illness. In 1903, Ilya Ilytch Metchnikoff (18451916) and Emile Roux (1853-1933) were able to reproduce syphilis, experimentally, in anthropoid apes. Treponema pallidum was discovered by scientists Fritz Richard Schaudinn (1871-1906) and Erich Hoffmann (1868-1959), in 1905. In the following year, German bacteriologist August von Wassermann (1868-1959), in collaboration with Albert Neisser (18551916) and Carl Bruck (1879-1944), developed the first method of diagnosis for this infirmity. Mercury, associated or not with warm baths, was, together with iodine, one of the first treatments used against the disease. Later on, therapy underwent a great evolution with the discovery of arsenic compound 606 (salvarsan) by Paul Ehrlich (1854-1915) in 1911. In 1921, derivatives of bismuth were introduced by Constantin Levaditi (1874-1953) and R. Sazerac. The treatment with antibiotics began in 1943. With the diffusion of penicillin, the incidence of syphilis was drastically reduced, to the point of being considered, nowadays, an easily controlled disease. In spite of this, in the last decades, a surprising increase of the infirmity was verified, a phenomenon perhaps caused by the inadequate use of medicaments and by the appearance of microorganisms resistant to penicillin. Another aspect to be considered is the presence of syphilis in patients bearing Acquired Immune-Deficiency Syndrome (AIDS), cases in which clinical conditions evolve more rapidly and in which treatment is less efficacious. Syphilis is also known as lues, venereal lues and avariosis. (See Hard chancre). Sources: Bier, 1957; Carrara, 1997; Houaiss, 2001; Koogan-Houaiss, 2004; Stedman, 1979; Veronesi, 1982; www.47; www.217; www.218; www.219; www.220; www.221; www.222.

Symptomatic asthma: the same as reflex asthma or pseudoasthma, occurring as a reflex during diseases of viscera, nose or other parts of the body. It may designate any variety of asthma distinct from bronchial or true asthma, as diabetic, arthritic, herpetic, toxic or uremic asthmas. (See Asthma).

Sources: Cardenal, 1960; Stedman, 1979.

 

T

Tannic acid [C H O ]: acid found in certain plants, especially in 76 52 46

the bark of oak and other trees of the family Fagaceae. Often used as mordent in photography colorants and in the production of paper, inks and drinks. In medicine, it is employed as astringent in the treatment of diarrheas and burnings. By the end of the 19 th century, tannic acid had ample acceptance as tonic and astringent, externally or internally taken. In the latter case, it is used against chronic inflammation of the buccal or pharyngeal mucous membranes and in the treatment of diphtheric angina, erysipela, chronic herpetic eruptions and pityriasis. Associated to benzoin it aborted smallpox pustules and attenuated deformed scars provoked by that disease.

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

Torula: ancient designation of the fungi belonging to the genus Cryptococcus, family Cryptococcaceae, among which it is included Cryptococcus neoformans, the causative agent of cryptocccosis in humans and animals. Cryptoccosis, which used to be called torulosis, is an infectious disease characterized by nodular lesions or abscesses, mostly in the brains and meninges, but also in joints, lungs and subcutaneous tissues. Miquel & Cambier (1902) defined torula as any imperfect fungus forming acids, as for instance citric and lactic acids. (See Cryptococcosis; Cryptococcus neoformans). Sources: Houaiss, 2001; Miquel & Cambier, 1902; Stedman, 1979.

Trichosporosis or trichosporiasis: an infection provoked by fungi of the genus Trichosporon, characterized by the presence of nodosities in hairs, also known as piedra negra and piedra alba or blanca. The former, caused by the fungus Piedraria hortai, attacks hairs principally; the latter, much rarer, is caused by Trichosporon beigelii, attacking the beard and mustache of young men. Both are related with precarious conditions of hygiene, but piedra negra occurs in regions of tropical climate and high pluviometric indices, whereas piedra blanca depends upon predisposing factors such as diabetes, AIDS (Acquired Immune Deficiency Syndrome) and other immune deficiencies.

Sources: Cardenal, 1960; Littré & Gilbert, 1908; Stedman, 1979; www.126

Tubercle: in anatomy, tubercles are small structures forming a rounded bulge on the surface of an organ, especially bones and certain regions of the brain. Examples are the quadrigeminous, mammillary tubercles (in the brain), Aranzi's tubercle on the median part of the sigmoid valves of the aorta etc. Pathologically, for D'Elia (1926), tubercle was a common name given to two morbid alterations, one of the skin (cutaneous tubercle), the other common to all tissues (tubercle proper). A tubercle is also defined as a small rounded tumor, characteristic of tuberculosis, formed in the interior of tissues.

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

Tuberculosis: also known as white plague, it is the disease that has the greatest number of deaths in the history of humanity, still representing a great menace; contemporary studies have shown that almost 2 billion inhabitants of the planet are infected, and that about 3 million people are killed by tuberculosis every year. It is an endemic, infecto-contagious disease provoked by Mycobacterium tuberculosis, or Koch's bacillus, a microorganism in the shape of a rod, discovered in 1882 by German doctor Robert Koch. This bacillus, devoid of movement of its own, needs oxygen to live and does not reproduce outside the body of man or other animal, except in laboratory cultures. Persons infected by the bacillus may not develop the disease. In most cases the invading bacteria are killed or rendered inactive by the natural defenses of the body. As a rule, the individual contracts the infection by inhaling bacilli floating in small drops of humidity in the air, bacilli let loose there by a patient of tuberculosis when he coughed or sneezed. The bacteria may also enter the body through contaminated food, as the milk of cows affected with tuberculosis. In countries where milk is pasteurized and animals periodically examined, the occurrence of this type of infection has become rare. The lungs constitute the main focus of the bacillus, but tuberculosis may affect almost all parts of the body: the lymphatic ganglia located at the thoracocervical region, pleurae, meninges, bones and joints, skin, kidneys, genital organs, eyes and intestines. All of these parts may harbor lesions caused by Koch's bacillus. One of the forms of the disease, "cutaneous tuberculosis" or "tuberculosis vorax" (as it rapidly consumes the skin and the cartilages), is also known as "vulgar lupus" - a nosological category created by Robert Willan (1757-1812) in the beginning of the 19 th century, but nowadays recognized as a modality of tuberculosis. The disease also attacks animals, especially domestic ones, as oxen, pigs and hens. In most cases, it develops when the natural defenses of the body are enfeebled by an infirmity or some other cause. Entering in contact with the organism, the invading germs activate the natural defenses, and many of them are killed. Moreover, defense cells surround groups of bacteria, forming hard tubercles within which the bacteria are kept alive, albeit inactive and innocuous (whence the term tuberculosis). Sometimes the disease manifests itself years after infection. The first invasion of germs, followed by the formation of tubercles, is called primary infection of primary complex, symptoms being rare during this period. Some other times, however, there are fever, nausea and eruptions on the skin. The first symptom of pulmonary tuberculosis is prolonged coughing, leading patients to believe they have only contracted a renitent cold. Next, there is considerable loss of weight. In severe and advanced cases, there may be hemorrhage, the patient eliminating blood by the mouth. The fight between bacilli and body defenses may last for a long time. If untreated, the patient becomes more and more infirm. New cavities are opened in the lungs and the germs spread to other parts of the body. In 1890 Robert Koch (1843-1910) announced the discovery of a sterile glycerinated extract obtained from tuberculosis bacilli cultures, giving to that substance the name tuberculin. He verified that the product was extremely toxic to animals with tuberculosis and relatively innocuous to healthy ones. At first Koch believed he had found the cure for tuberculosis, but further experiments he carried out soon demonstrated the inefficacy of the treatment. Abandoned as a therapeutic method, tuberculin passed to be utilized in the diagnostic of the disease. As therapy for tuberculosis, initially prevailed the treatment made in sanatoriums, establishments created in Europe, America and other parts of the world starting in the second half of the 19 th century. The objective of the treatment was the spontaneous cure of the patient submitted to adequate conditions: rest, overfeeding, favorable climate and the isolation. In 1909, two researchers of Pasteur Institute, Albert Calmette (1863-1933) and Camille Guerin (1872-1961) reported the development of a bacillus with attenuated virulence possessing immunizing capacity against tuberculosis. After a series of tests, BCG, the first attenuated bacterial immunizer, came to be regularly used as vaccine. The scientific progress verified during the first decades of the 20th century helped to refute some beliefs accepted until then about the disease, among them, its supposed hereditary character and the importance of the climate for the patient's recovery. In 1944, the discovery of an antibiotics, streptomycin, by Selman Waksman (1888-1973) and collaborators, opened a new perspective for the treatment of tuberculosis. Other significant advance was the discovery of isoniazid (hydrazid of isonicotinic acid) in 1951, a substance that prevents proliferation of the bacilli. Once the efficacy of antibiotics for the cure of tuberculosis was corroborated, its treatment came to be made in ambulatories, in most cases, being unnecessary the internment of the patient. As a result, sanatoriums were gradually inactivated. In the past, in sanatoriums, a surgery was made to make a sick lung retract, so it stopped functioning. Doctors still opt for surgery in certain cases, but, instead of provoking the lung's collapse, they only extirpate the affected part. The remainder of the lung keeps functioning normally. The consolidation of chemotherapy by means of antibiotics, together with the adoption of prophylactic measures and the simplification of the diagnostic, promoted a radical transformation in the epidemiological profile of the disease in the 1950's and 1960's, materialized into an accentuated decline of mortality indexes. Notwithstanding, the continual use of antibiotics, as well as the prescription of inadequate therapies, occasioned the appearance of drug resistant bacilli. The problem was partly supplanted by the development of new chemotherapic agents and by advances obtained in the field of microbiology. As the resistance to bacillus is in part determined by the immune system, in the last decades the association of tuberculosis with Aids became frequent. In the last years a growing number of resistant bacilli has been verified. In addition to isoniazida and streptomycin, the drugs more used in the treatment of tuberculosis are etambutol, paraminosalicilic acid - PAS and rifampina. In spite of the considerable reduction of cases of tuberculosis in many nations, including in Brazil, the disease still is a severe public health problem in developing countries, principally in Africa, where there is scarcity of medicaments. Tuberculosis is a very old disease, having been found in lesions of probably tuberculous etiology in bones of Egyptian mummies dating from 3700 b.C. Before affecting man, it was an endemic disease of animals from the Paleolithic Period. It is believed that the agent of tuberculosis had bovine cattle as its original host, Mycobacterium tuberculosis being a mutation of Mycobacterium bovis, favored by the contact of man with cattle and the increase of demographic density of human populations. The infirmity spread to such a point through western Europe that it came to be the cause of 25% of deaths. It was infrequent or unknown in America, having been imported by European immigrants. However, there are studies indicating that it could have been the cause of some deaths in pre-Columbian Peru. Up to the beginning of the 20th century it was practically unknown in sub-Saharan Africa and in the middle of that century it had not yet reached New Guinea, Papua and Indonesia. (See Koch's Lymph). Sources: www.49; www.194; www.195; www.196; www.197; www.200.

Tuberculosis cutis verrucosa: a lesion of the skin caused by Koch's bacillus presenting a verrucose surface with a chronic inflammatory base with suppuration. Also known as tuberculosis verrucosa of the skin, verrucose or papulous lupus, tuberculous wart and scofulodermia verrucosa.

Sources: Cardenal, 1960; Stedman, 1979.

Tuberculosis miliaris acuta or acute granulous tuberculosis: one of the two main forms of human tuberculosis, characterized by the generalized dissemination of Mycobacterim tuberculosis in the organism and the formation of minute and countless tubercles in various organs and tissues. It differs from the localized form, which is limited to a specific organ or tissue (lung, bone, kidney, etc.). (See Tuberculosis).

Sources: D'Elia, 1926; Ferreira, 1999; Larousse, 1971; Stedman, 1979.

Tuberculous or tuberose Lupus: chronic cutaneous infirmity characterized by the development of nodular lesions on the face, generally around nose and ears. The term was originally used to designate any type of corrosive ulceration of the skin. In 1808, Robert Willan (1757-1812) differentiated lupus from other cutaneous infirmities, classifying it as a chronic disease with the name of vulgar lupus. It was also called cutaneous tuberculosis. In 1851, Pierre Louis Alphée Cazenave (1795-1877) described erithematous lupus, distinguishing it from the form identified by Willan. Nowadays the word lupus is always accompanied by an adjective specifying its type. (See Erythematous lupus).

Sources: D'Elia, 1926; Ferreira, 1999; Houaiss, 2001; Landouzy & Jayle, 1902; www.182; www.183.

Tularaemia: acute infecto-contagious disease of moderate gravity, provoked by inoculation or ingestion of a Gram-negative bacterium -Francisella tularensis (previously known as Bacterium tularense, Pasteurella tularensis). It is transmitted to man through contact with infected animals or through ingestion of contaminated meat. It may also be conveyed through the bites of infected arthropods such as ticks, lice, horseflies and mosquitoes. It shows a ulcero-ganglionary form generally localized in the region of the bite, and a pleuro-pulmonary form. Its characteristic symptoms are fever, headache, vomit and adenopathy. In 1910, George Walter McCoy (18761952) discovered the disease in wild animals in Tulare County, California. Two years later, the same McCoy, together with Charles W. Chapin, described the etiological agent, calling it Bacterium tularense. In 1914 the first human manifestation of the infirmity was recognized by William Buchanan Wherry (1874-1936) and B. H. Lamb. As an homage to North American doctor Edward Francis (1872-1957), responsible for important studies about this disease, agent was renamed Francisella tularensis.

Sources: Bier, 1957; Larousse, 1971; Houaiss, 2001; Veronesi, 1982.

 

U

Uffelmann, Julius August Christian: German doctor born in Hannover, in 1837, died in 1894. After studying theology and philology in Göttingen, he studied medical sciences. He was a physician in Hameln, Privat-Dozent in Rostock, where he taught from 1876 on, and ausserordentlicher Professor (extraordinary professor) three years later. He published papers about several themes and, in his Manual of domestic hygiene of the child (1891), defended the importance of diet and hygiene for the control of diseases.

Sources: www.181; www.167; www.166.

Ulcer: an open lesion with loss of substance in a cutaneous or mucous tissue, causing disintegration and necrosis. Ulcers are more likely to show in parts of the body with bad blood circulation. Even a small blow on those parts may lead to an ulceration. A wound due to traumatism may become ulcerated if an infection occurs.

Sources: Houaiss, 2001; Koogan-Houaiss, 2004; Stedman, 1979.

Unna, Paul Gerson: German dermatologist born in Hamburg on September 8, 1850. He studied medicine first at Heidelberg University, which he entered in 1850, then at Leipzig and at Strasburg University, where he graduated, under the orientation of Waldeyer, in 1875. His doctoral thesis -Über die Entwicklung der Haut (On the development of skin) brought to light entirely new knowledge about the different parts and constituting elements of skin. In order to make his observations, Unna employed osmic acid and a new dye, picro-carmine, recently discovered by Ranvier. The results of his work would be partially published in his Handbuch der speciellen Pathologie und Therapie, in 1883. Once graduated, Unna went to Vienna, where he studied under Ferdinand von Hebra's (1816-1880), Moriz Kaposi's (1837-1902) and Heinrich Auspitz's (1835-1886) orientation. In 1877, together with Auspitz, he published two articles on pathological anatomy of syphilitic chancre, in Vierteljahresschrift für Dermatologie und Syphilis. Going back to Hamburg in 1876, he was hired as assistant doctor in the syphilis section of St. Georger Hospital, in Engel Reimers, an activity that he tried to conciliate with his practice at his father's clinic in Hamburg. In the beginning of the 1880's, he founded his own clinic, dedicated to skin diseases. With Oskar Lassar and Hans Hebra, he created, in 1882, the Monatshefte für praktische Dermatologie (now Dermatoloische Wochenschrift), the first dermatological journal in Germany and one of the main references of that specialty in the world. The clinic was soon rendered insufficient to attend the growing demand. Unna decided therefore to abandon general clinics and dedicate himself solely to dermatology. In 1884, in a suburb of Hamburg, he inaugurated a modern institute of dermatological training, which came to be attended by students from all over the world. The Dermatologikum also attracted doctors of several nationalities, many of them considered pioneers in their respective countries. One of them was Adolpho Lutz, who arrived in Hamburg in March, 1885. Under the orientation of Unna, the Swiss-Brazilian physician developed an important work on the bacteriology of leprosy and other dermatological diseases. In his article published in 1886, in Monatshefte für praktische Dermatologie ("Zur Morphologie des Mikroorganismen der Lepra"), Lutz proposed a new classification for the microorganism discovered by Gehard Amauer Hansen (1841-1912). Considering it a new genus, he called it Coccothrix. Unna worked for 25 years on the histology of leprosy, having made important contributions to bacteriology, pathology and the therapy of the disease, creating his own histological methods and staining techniques for cells and tissues. In 1891 he discovered plasmatic cells and, in the course of time, verified that they were fundamental components of chronic infections and infectious neoplasias. He also established the difference among several types of adipose tissues and undertook historical studies about the concept of eczema. In 1894 he published his monumental Die Histopathologie der Hautkrankheiten (Histopathology of skin diseases), a work that consolidated his prestige as one of the most important dermatologists in the world. From 1906 on, he directed his laboratory researches to the field of chemistry. With Golodetz, he clarified the until then imprecise chemistry of corneous substances, a great advance in dermatology. Researching the biochemical processes of skin, he discovere stratum granulosum. In 1911, he verified on the skin the presence of areas with an excess of oxygen (Sauerstofforte) and of areas which consumed much oxygen (Reduktionsorte). Two years later, using the method of Chromolyse, he tried to establish a bridge between histology and the chemistry of tissues. Based on a systematic series of alternating tests with chemical solvents and dyes in sections of congealed tissue, the new method aimed at determining whether the element of the tissue to be examined was or not dissolved after been stained. In 1928 he published Histochemie der Haut (Histochemistry of the skin), compiling his main conclusions about tissue chemistry. Besides his works on dermopathology, he left notable contributions in the field of clinical dermatology. He was the author of fundamental studies about impetigo, lichens, diseases of nails and erythema, among other illnesses. In addition, he described a chronic affection of the skin characterized by the inflammation of regions rich in sebaceous glands, especially the scalp and areas on the face and trunk. Of unknown origin, it was called Unna's disease. His contributions to therapy have been of great importance. Unna thoroughly studied the effect of reduction agents on skin, among them chrysarobin, pyrogallol, resorcin and ichthyol. He introduced the use of medical soaps and recommended skin cauterization for the treatment of small benign tumors and pustular lesions. He developed a paste composed of zinc oxide, gum mucilage and glycerin, which became known as Unna's ointment, still used today in the treatment of varicose ulcers and pruriginous dermatoses. Even before the introduction of radioactive treatments, he worked in the eradication of lupus, which he considered curable. In the field of cosmetics, he defended the use of colored ointments, pastes and powders for face and hands. He published over 150 articles and several monographs. Kriegsaphorisms eines Dermatologen (War aphorisms of a dermatologist) was created during World War I, with the intention of training doctors of the German armed forces in the treatment of common dermatoses. Unna also wrote Die allgemeine Therapie der Haut-Krankheiten (General therapy of skin diseases) and Diagnose und Behandlung von Hautkrankheiten durch den praktichen Arzt (Diagnosis and treatment of skin disease by physicians). Unna, who had always despised academic positions and had many warm disputes with many of those who had them, became, in 1907, full professor of Eppendorf Krankenhaus. The following year, he assumed the position of head-doctor of that institution and, in 1919, was named professor of dermatology of the University of Hamburg. Besides the above mentioned work, he authored the chapter on dermatology of von Orth's (1847-1923) Lehrbuch der pathologischen Anatomie, and was coeditor of the Internationaler Atlas seltener Hautkrankheiten (Hamburg and Leipzig, 1889-1899). He died in Hamburg, victimized by flu, on January 29, 1929.

(See Chrysarobin; Leprosy; Lichen; Pyrogallic acid; Staining; Unna's ointment).

Sources: Cardenal, 1960; Larousse, 1971; Hollander, 1987; Olpp, 1932; www.51; www.223.

Unna's ointment: a paste of zinc oxide, gum mucilage and glycerin, created by German dermatologist Paul Gerson Unna (1850-1929). It was used in the treatment of varicose ulcers. Legs were wraped up with bindings impregnated with the ointment, a curative procedure that became known as "Unna's boot". It is still employed nowadays in the control of hypertension of lower limbs, to help the cicatrization of venous ulcers. Some sources define Unna's boot as a bandage impregnated with paste of zinc oxide at 10%, glycerin, petrolatum, antiseptic agents and cicatrisants. (See Unna, Paul Gerson).

Fonte: Cardenal, 1960; Larousse, 1971; www.51.

 

V

Van Gieson's staining: a method of staining histological preparations with the oldest dye in usage, van Gieson's, constituted by 0.05 part of acid fuchsine and 100 parts of a solution of saturated picric acid. In the presence of picric acid, the acid fuchsine stains the collagenous tissue in a very elective, intense red. The method has the shortcoming of giving a too pale coloration to cytoplasms susceptible to picric acid. (See Fuchsin; Picric acid).

Sources: Cardenal, 1947; Fernandes, 1943.

Vesicular pityriasis: also known as pityriasis versicolor; tinea versicolor; pano and pano branco (in Brazil); tinea furfuracea, chromophytosis and Eichstedt's disease, after the German doctor Karl Ferdinand Eichstedt (18161882). It is a common, superficial, fungal infection caused by the saprophytic fungus Piryrosporon orbiculare, also called Microsporon furfur or Malassezia furfur, which normally lives on the skin of genetically predisposed, generally young, individuals. The disease is identified by scaly, oval lesions of a red to brown or white color, located on the neck, trunk, arms and cervical region. It may ascend to the face or spread through the forearms, abdomen, flanks, buttocks and thighs, merging into larger lesions with irregular borders, sometimes quite extended. As the name "versicolor" itself suggests, lesions change color. During summer months, when the skin becomes exposed to ultraviolet light, lesions become hyperpigmented, as the infection prevents the fabrication of pigment by the affected skin. Examination of the lesion with KOH reveals yeast-like forms budding and claviform hyphae. According to D'Elia (1926), treatment consisted of sulphurous baths, rubbing with black soap, application of lotion with chloral, van Swieten's liquid and iodine tinctures. Nowadays treatment is made with creams, unguents or lotions of econazol, myconazol, clotrimazol and cyclopyrox, applied twice or thrice a day for three to four weeks (Wyngaarden, 1992). Another alternative consists in daily soaping, for three to four weeks, with sodium hyposulfate at 10-20%, which is left to dry over the skin, or of selenium sulfate at 2.5% (the base of a commercial shampoo), daily, either twice or thrice a week, letting it act for 15 to 20 minutes. Alcohol salicylate (4%) with benzoic acid (4%) is also useful. Tolnaftate as lotion or cream is an active topical drug. Hypochromy tends to disappear more rapidly when exposed to solar light after treatment, and repigmentation may be accelerated by means of local photosensibilizers (Veronesi, 1982). (See Pityriasis; Pityriasis circinata marginata).

Sources: D'Elia, 1926; Houaiss, 2001; Stedman, 1979; Veronesi, 1982; Wyngaarden, 1992.

Vesuvine: term originated from "Vesuvius", Italian volcano. A brown-colored dye used in microscopy, constituted from the action of nitrous acid upon metaphenylenediamine. Very much used in histological techniques in aqueous solution at 1 to 100. Also known as Bismarck's brown or triamidobenzene.

Sources: Cardenal, 1960; Larousse, 1971.

Vitiligo: a dischromatic lesion of the skin, of unknown cause, characterized by the localized loss of pigmentation and the presence of white spots of various sizes and generally with asymmetric distribution. The skin surrounding the lesioned areas is normally hyperpigmented, and the hairs on the affected parts are almost always white. Also known as acquired leucodermy or acquired leucopathy.

Sources: D'Elia, 1926; Ferreira, 1999; Houaiss, 2001; Landouzy & Jayle, 1902; Littré & Gilbert, 1908; Stedman, 1979.

Voltolini, Friedrich E. R.: German doctor born in Elsterwerda on June 17, 1819, died on September 10, 1889. He is mainly renowned for his activities in otorhinolaryngology. In this medical specialty he was a pioneer in the application of galvanocaustics in diseases of the larynx and nose, by perfecting the illumination of the laryngoscope and by the adaptation of this instrument as otoscope. He performed clinical activities in Berlin, Gross-Strehlitz and Lauenburg; became a municipal doctor in Falkenberg (Upper Silesia) in 1852 and Privat-Dozent of otology and laringology in Breslau from 1862 on. Six years afterwards, he assumed the position of ausserordentlicher Professor (extraordinary professor) at the University of Breslau.

Sources: Encyclopædia Britannica, 2001; www.176; www.179; www.211; www.199.

 

W

Weigert, Karl: German pathologist (1845-1904), who, from 1871 on, developed ingenious staining methods for different species of bacteria, enormously contributing to the microscopic investigation of these beings. He also created methods for the observation of myelin, of elastic fibers, of fibrin and other organic structures. Weigert verified that a solution of fuchsin, resorcin and iron chloride rendered elastic fibers bluish. Fibrin is dyed in a solution of violet crystal-aniline, then treated with a solution of iodine-potassium iodide and then discolored in oily aniline and xylol; the fibrin thus acquires a dark-blue coloration. Equal results are obtained for myelin, when it is dyed with iron chloride and hematoxylin, the degenerated portions acquiring a yellowish taint. A more complex method renders the neuroglia and the nuclei of its cells bluish, using cupric hematoxylin for the nervous tissues. In relation to Actinomycetes, Weigert recommended soaking them for an hour in a dark-red solution of orseillin in twenty parts of alcohol, five parts of acetic acid and forty parts of distilled water; next, the compound should be washed and stained with an 1% aqueous solution of violet crystal, and finally decolorized with 60% alcohol. Iron hematoxylin, a solution containing hematoxylin, iron chloride and hydrochloric acid, is used as a dye for nuclei of cells. Other techniques created by the German pathologist are still in use, or were perfected; his name is also given to a law according to which the loss or destruction of a part or an element of the organic world may result into a compensating overproduction, especially in processes of regeneration or repairing of tissues and bones. (See Fuchsin; Staining).

Sources: Cardenal, 1960; Fernandes, 1943; Stedman, 1979; www.46.

Wernicke, Roberto Johann: Argentinian parasitologist, son of German immigrants, Wernicke was born in 1854 and died in 1922. He obtained his MD at Jena University, Germany, taught pathology at the Faculty of Medicine in Buenos Aires. Together with his disciple Alejandro Posadas (1870-1902), he was the first to describe a new skin disease initially called fungoid mycosis with psoropermians, and, later on, as Posadas-Wernicke's disease or coccidioidomycosis. Both authors published their discoveries independently, in 1892. Wernicke in "Ueber einen Protozoenbefund bei Mycosis fungoides", in the Centralblatt für Baktyeriologie und Parasitenkunde (1892; 12: 859-61), and Posadas in "Un nuevo caso de micosis fungoidea con psorospermia", in the journal Círculo Médico Argentino (1892; 15: 585-97). In 1893, a new case of the disease was observed by Canadian surgeon Emmet Rixford (1865-1938). New cases were registered in California in 1894 and 1896. The causative organism of that disease was called Coccidioides immitis and definitely characterized by William Ophüls and H. C. Moffit (1871-1933) in "A new pathogenic mould formerly described as a protozoan: Coccidioides immitis pyogenes: Preliminary report", published in the Philadelphia Medical Journal, 1900, v.5, p.1471-2. Also with Posadas, Wernicke was the first to report a case of rhinosporidiosis. (See Coccidioidomycosis; Coccidium; Posadas, Alejandro; Psorospermosis).

Sources: www.19; www.29; www.225.

Wilson, Erasmus: English doctor (18091884), known for his works as anatomist and dermatologist. He was president of the College of Surgeons and of the Biblical Archeology Society and one of the first stockholders of the London & Provincial Turkish Bath Company Ltd. He founded and directed the chair of dermatology of the Royal College of Physicians. He brought to England, from Egypt, the obelisk known as Cleopatra's needle, still found at the margin of the Thames in London. In 1869 he described and named lichen planus, a dermatosis that Ferdinand von Hebra had probably identified as lichen ruber. (See Lichen planus; Lichen ruber).

Sources: Freedberg, 1999; www.53; www.54.

Wucherer, Otto Eduard Heinrich: the son of a Dutch mother and of a German merchant, he was born on July 7, 1820, in the city of Oporto, Portugal, and died in Salvador, Bahia, Brazil, on May 7, 1873. As his father became established as a merchant in Salvador, he lived between his sixth and seventh years in that Brazilian city, moving afterwards to the German district of Baden-Württemberg. He graduated in medicine at the University of Tübingen. Returning to Bahia in 1843, he practiced medicine in several towns of that province before establishing himself in Salvador, in 1847. Attuned with the discussions and theoretical problems of medical topography and geography, he dedicated himself, together with other physicians of that province - especially John Ligertwood Paterson (1820-1882) and José Francisco da Silva Lima (18261910) - to the study of tuberculosis, leprosy and ophidism, in addition to diseases associated to tropical climates, notably opilation (ancylostomiasis), beriberi, schistosomiasis, filariasis and the ainhum. Published in the Gazeta Médica da Bahia, a journal that circulated from 1866 to 1915, Wucherer's studies, and those of other members of his group, ended up by rendering them famous, originating what was afterwards called the Tropicalist School of Bahia.

Sources: Barreto & Aras, 2003; Edler, 2002; Larousse, 1971;www.155.

 

Y

Yaws: also known as bubas, pian, rupia, Amboine button, frambesia, frambesialike mycosis, polypapillome, tropical granulome, zymotic papillome or yet Breda's disease. A contagious tropical disease caused by spirochete Treponema pertenue, it is characterized by cutaneous lesions followed by generalized granulomatose eruption and sometimes by belated destructive lesions of the skin and bones. The disease may destroy the nose cartilage, bones and joints, to the point of invalidating a patient. Yaws may be cured with penicillin injections. The generalized use of this drug, since the 1950's, considerably decreased the number of cases all over the world. The spirochetes of yaws, very similar to those causing syphilis, penetrate the body through cuts or scratches in the skin, the disease being contracted, in many cases, through contact with an already infected person. From the morphological point of view, it is practically impossible to differentiate Treponema pertenue from the syphilis treponeme. However, contrariwise to the latter, that of yaws does not affect the central nervous or the cardiovascular systems. Endemic in the beginning of the 20th century, the disease assailed especially the tropical regions of Africa and the Americas, Polynesia, Ceylon (Sri Lanka), Malaysia and other parts of eastern tropics. In the regions where it occurred in endemic form, it frequently became epidemic.

(See Spirochaeta pertenuis).

Sources: Cardenal, 1947; D'Elia, 1926; Houaiss, 2001; Koogan-Houaiss, 2004; Murray, 1910; Stedman, 1979; Veronesi, 1982.

Yeast: unicellular Ascomycetes fungi that produce alcoholic fermentation of sugared solutions or used to leaven bread. The most important genus is Saccharomyces. (See Fungi).

Sources: Koogan-Houaiss, 2004.

 

Z

Zambaco, Démétrius Alexandre: descendant of Greeks, he is also known as Dimítrios Zambakós pasás or Zambaco Pasha, reference made to the title received from the Ottoman Khedive of Egypt for medical services rendered to that country. Born in Constantinople, in Turkey, on May 6, 1831, he obtained French citizenship after his transference to Paris to study at the Faculty of Medicine of Paris. Head of clinic of that faculty and national correspondent by the Division of Anatomy and Physiology of the Academy of Medicine, he authored several important papers on leprosy, all published in Paris: Mémoire sur la lèpre observée à Constantinople (1887), Voyages chez les lépreux (1891), Les Lépreux ambulants de Constantinople (1897), La lèpre à travers les siècles et les contrées (1914). According to William Tebb, during the First International Congress of Dermatology and Syphilography, held in the French capital in August, 1889, Zambaco communicated the results of his researches on leprosy carried out on the isle of Metilene, in Turkey, defending the theory that the disease was not transferred from person to person. The inexistence of cases among the fifteen thousand Muslims inhabiting the island seemed to corroborate his ideas of the non-contagiousness of the disease. In the history of medicine his name is also associated to the propositions, defended by the end of the 19th century, of cauterization and removal of the clitoris to diminish the supposed feminine propensity to masturbation. Among his papers about human sexuality, may be cited Onanisme avec troubles nerveux chez deux petites filles (1882) and Les Eunuques d'aujourd'hui et ceux de jadis (Paris, 1911). He was a member of the Academies of Medicine of St. Petersburg and Vienna and president of the Constantinople Society of Medicine. He died in Cairo on November 17, 1913. (See Leprosy).

Sources: Houaiss, 2001; www.198; www.161; www.133.

Ziemssen, Hugo Wilhelm von: German doctor born in Greifswald on December 13, 1829, Ziemssen died in Munich, on January 21, 1902. He taught medical clinic at Erlangen University in 1862, and at Munich University the following year. He took is MD only in 1880, already as pathologist and director of the Municipal Clinic of Munich, with a thesis entitled On myelin, pigment and micrococci of the sputum. He is recognized for introducing examination methods and treatments with electricity in German medicine, and for his studies on heart movements.

Sources: Der Grosse, 1952-1960; www.229; www.162; www.167;www.48.

Zooglaea: ancient name given to a mass of bacteria kept aggregated due to the production of a gelatinous substance.

(See Bacteria).

Sources: Ferreira, 1999; Houaiss, 2001; Littré & Gilbert, 1908; Stedman, 1979.