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Lhermitte's sign. From observation to eponym.

The Lhermitte's sign was first described by Pierre Marie and Chatelin in 1917. Lhermitte reported on this symptom in 1920, and in 1924 he published the seminal article on the subject. In 1928, it was introduced to the American literature, and it was around that time that the symptom became well known. The historic development of this observation into an eponym is documented.

Eponyms

The artificial kidney. 1952.

In this classic article, reprinted from the March 1952 issue of the American Journal of Nursing, Barbara K. Coleman, RN, and John P. Merrill, MD, describe the early artificial kidney, which was being used experimentally to treat acute renal failure. This is the first article published in the nursing literature addressing the role of the dialysis nurse.

History, 20th Century

Excellence in nursing. 1969.

We talk a great deal about excellence in nursing and commit ourselves to this quality in stated philosophies and goals. When it comes to defining or measuring excellence, however, a variety of views emerge. In this article, a nurse--one who is universally considered among the excellent because of her inspired teaching, her many-faceted contributions to nursing philosophy and literature, and her abiding concern for patient care--describes her personal concept of excellence.

Education, Nursing

The nurse of tomorrow.

Even since 1950, the seventh of April has been celebrated as World Health Day, because it marks the date in 1948 when WHO was founded. Each year a theme related to international public health has been chosen for World Health Day, with an appropriate slogan. This year the slogan is "Health for all--all for health." In 1954, "The nurse--pioneer of health" was selected as the slogan "to", in the words of former WHO Director-General Marcolino Candau, "bring about a clearer realization of the fundamental importance of the nurse's work for the health of the world." At the time Dr Candau took the opportunity to acknowledge "the valuable support and cooperation which WHO has consistently received from the ICN both before and since its admission into official relationship." To promote the nursing theme in 1954, material was prepared by the WHO for distribution to organizations and media around the world. Included in its kit was the following article by Daisy Bridges, ICN Executive Secretary 1948-61. Written 35 years ago, when ICN had already been in existence for over a half century, this article aptly expresses an ICN philosophy that remains unchanged and illustrates how ICN since its inception in 1899 has been working toward developing a nursing profession that can, with other health disciplines, not only help care for the sick, prevent disease and promote health but share in the planning of such a service and take the responsibility for its own professional contribution.

Global Health

Lester R. Dragstedt 1893-1975. Chronic ulcerative colitis. A summary of evidence implicating Bacterium necrophorum as an etiologic agent.

Lester Dragstedt was born in Anaconda, Montana, the son of Swedish immigrant parents. His entire college and professional education took place at the University of Chicago, where he received a B.S. degree in 1915, a master's degree in physiology in 1916, a Ph.D. in physiology in 1920, and the M.D. degree (from Rush) in 1921. His first academic appointment was as a physiologist at the State University of Iowa. In 1925 Dragstedt was recruited by Dallas B. Phemister to help design the new University Hospital research facilities on the campus of the University of Chicago. Following completion of this responsibility Phemister appointed Dragstedt as Associate Professor of Surgery, stating, "I can teach surgery to a physiologist; I am interested in teaching physiology to surgeons." In 1947 Dragstedt succeeded Phemister as chairman, a post he occupied until his retirement in 1959. Dragstedt was regarded as a skilled clinician as well as a dexterous and artistic surgeon. But he was particularly recognized for his contributions as physiologist-surgeon in the treatment of diseases of the pancreas, parathyroids, and especially diseases of the stomach. In 1943, he performed a transthoracic vagotomy on a patient with a duodenal ulcer who refused to accept the standard operation, subtotal gastrectomy. A lesser known but classical work of Dragstedt and his coworkers is reproduced here for this series. Dragstedt was the originator of the skin-grafted ileostomy in the treatment of ulcerative colitis. The author describes a complete "take" of the split-thickness graft in four patients, although he observed that the "resulting ileostomy looked somewhat like a penis." One can only surmise about the psychologic disability that would be produced. The stoma could, however, be fitted with an appliance that would minimize the risk of abdominal wall digestion. When reading the article and understanding the experimental studies proposing the possible causative organism of ulcerative colitis, one is impressed by Dragstedt's creative thinking. Dragstedt's renown as a basic scientist was illustrated by his election to the National Academy of Sciences. Following his Chicago retirement he became again a full-time physiologist with appointments as research professor in both the department of surgery and the department of physiology at the University of Florida College of Medicine. Active until the end, he died at his summer home on Elk Lake, Michigan on July 16, 1975.

Colitis, Ulcerative

Artificial impaction in hip fracture. By F. J. Cotton, 1911.

Frederic Jay Cotton (Fig. 1) was born in Prescott, Wisconsin, and educated at Harvard. After postgraduate study in New York and in Europe, he returned to Boston where he had an association with most of the important hospitals. In addition to great surgical talent, he also was an able administrator and medical politician. He is remembered primarily for his work on fractures, which is summarized in his book, Dislocations and Joint Fractures. The two editions of this book were illustrated by many of the author's own drawings. Cotton was a founder of the American College of Surgeons and served as Regent of the College as well as on the Committee on Fractures. He served in both the Spanish American War and World War I. In the summer of 1918, he was the Chief of Surgery at Walter Reed Army Hospital in Washington, D.C. This article on "Artificial Impaction in Hip Fracture" is an example of the application of a clinical observation to the development of an improvement in the care of patients. It had been known for a long time that impacted fractures of the neck of the femur healed, while displaced fractures did not. Cotton was the first to suggest that impaction, after reduction of the fracture, would be of value. Cotton published three additional papers on the use of impaction in the treatment of hip fractures, the last in 1938, the year of his death. Impaction of fractures of the neck of the femur after reduction of the displacement was rapidly incorporated into all of the procedures for internal fixation of such injuries.

Femoral Neck Fractures