This document provides biographical information on several female scientists and physicians who made important contributions to medicine and whose names became associated with medical eponyms. It discusses the accomplishments and background of Dorothy Andersen, who described glycogen storage disease Type IV; Virginia Apgar, who developed the Apgar score; Winifred Ashby, who established the correct red cell lifespan; Julia Bell, associated with Martin-Bell syndrome; Emma Call, associated with Call-Exner bodies; and Myrtelle Canavan, who described familial spongy degeneration in infants.
2. ESSAYS IN MEDICAL EPONYMS 1327
FIG. 1. Dorothy Andersen. Portrait by Frank Slater. (Re-
produced with permission from the Journal of Pediatrics
1964;65:476–9.)
FIG. 3. Winifred Ashby. (By permission of the Mayo
described in current hematology texts. Winifred Ashby Foundation.)
(1879–1975) (Fig. 3), pathologist, was born in London,
England, and when 14 years old migrated with her par- A new syndrome of X-linked mental retardation was
ents to the United States. She graduated BS from described by Joan Atkin and Katherine Flaitz8 and col-
Chicago University in 1903 and MS from Washington leagues, known as the Atkin–Flaitz syndrome. Addi-
University, St. Louis, in 1905, studied malnutrition in the tional features include short stature, macrocephaly,
Philippines, and then returned to the United States where “coarse” facial appearance, but normal chromosomes.
she taught school physics and chemistry. She began a Both women are geneticists who worked at the time in
Fellowship at the Mayo Clinic where she became the Virginia and Iowa, respectively.
first person to establish the correct red cell life span. She The Epstein–Barr virus (EBV) was named after
made contributions to the diagnosis of syphilis and stud- Yvonne Barr (Balding) (Fig. 4) and Anthony Epstein,
ied carbonic anhydrase in the brain. She was a gifted who discovered the virus in 1964. 25–27 Dr. Barr
musician and composer. She left the Mayo Clinic in 1924 was born in Conlow, Republic of Ireland. She was head
and worked at St. Elizabeth Hospital, Washington, DC, prefect at Banbridge Academy Secondary School and
until her retirement.21,30 According to Dacie,21 “…she graduated, with honors, from Trinity College, Dublin,
was ahead of her time; her papers remained on library majoring in zoology. After various research appoint-
shelves largely unread and her technique was relatively ments she received her PhD from the University of
unused until the late 1930s.” She is remembered now, London. Working in Epstein’s laboratory, the virus that
but much of her career was spent in obscurity. ultimately bears their names was discovered (Bert Achong,
from Trinidad, was the third collaborator). “The progress
FIG. 2. Virginia Apgar. Courtesy of A.C. Long Health Sci-
ences Library, Columbia University, New York, NY. FIG. 4. Yvonne Barr.
Am J Surg Pathol, Vol. 25, No. 10, 2001
3. 1328 A. G. ÖSTÖR
Melbourne ever since (in a suburb neighboring the au-
thor’s). While raising two children she obtained a
Diploma of Education and taught biology in secondary
schools for 20 years. She is now retired and enjoys em-
broidery, crafts, theatre, and traveling (personal commu-
nication, 1999). Serendipity has also played a major part
in the “finding” of Dr. Barr who preferred living incog-
nito, away from the limelight (rather like the “finding” of
Livingstone by Stanley, who was never really lost).
Julia Bell, (1879–1979) (Fig. 5) (yes, she lived to be
100!), was a pioneer of human genetics and gave her
name to the Martin–Bell syndrome (also known as the
“fragile X” syndrome), X-linked mental retardation,
macro-orchidism, and a characteristic but variable fa-
cies.34 Dr. Bell was educated at Nottingham Girls’ High
School and Girton College, Cambridge. At that time
women were not eligible for a degree at Cambridge
University, and she therefore graduated in mathematics
at Trinity College, Dublin. Bell spent the next 6 years
investigating solar parallax at Cambridge Observatory
FIG. 5. Julia Bell. Courtesy of C.V. Mosby, St. Louis, MO.
and then moved to University College, London, where
she was employed as an assistant in statistics. In 1914,
of science is littered with happy coincidences, chance prompted by her mentor Pearson, she commenced medi-
observations and meetings that mark the beginning of cal studies at the London School of Medicine for Women
successful lines of research. But few have involved as (Royal Free Hospital) and St. Mary’s Hospital, qualify-
much serendipity in their early stages as the EBV,” wrote ing in 1920 and being elected to the fellowship of the
John Galloway celebrating the 25th anniversary of its Royal College of Physicians in 1938. The major portion
discovery.31 The search, which led ultimately to the dis- of Bell’s career was spent at the Galton Laboratory,
covery of the virus, was set in train on March 22, 1961. University College, where she was a member of the per-
On that day an unknown English “bush surgeon” from manent staff of the Medical Research Council. Her Trea-
Uganda, Denis Burkitt, gave at the Middlesex Hospital in sury of Human Inheritance was the first systematic at-
London the first account outside Africa of an unusual, tempt to document the distribution of human disease
malignant childhood lymphoma, which now bears his within families. Bell received the Weldon medal from
name.10 His first publication in 1958 had attracted no Oxford University for her contributions to biometric sci-
attention at all. According to Epstein, “it was a fortunate ence. She was the author of many classic papers, includ-
chance, therefore, which took me to the talk in which ing an article with J. B. S. Haldane on linkage of the
Burkitt described how he came to realize in the course of genes for color blindness and hemophilia. This was the
his surgical work that the many seemingly different lym- first demonstration “that the principles of linkage which
phoid cancers of children in Africa were not disparate have been worked out for other animals also hold good
entities, but all facets of a single, hitherto unrecognised for man.” Age did not impede her academic activities,
tumour syndrome, commoner in endemic regions than all and she wrote an original article on rubella and preg-
other children’s cancers added together.”28 The disease nancy at 80. Bell retired when she was 86, having out-
appeared to have a characteristic geographic distribution lived three Galton professors: Pearson, Fisher, and
related to climate, which suggested transmission by an Penrose. She had been a proponent of Women’s Suffrage
insect vector. Epstein decided the cause must be an on- in her youth, although she was never involved in militant
cogenic virus. Although viruses were known to cause activity. She remained unmarried but had the compan-
tumors in animals for decades, there was no evidence ionship and affection of many relatives and friends. Bell
kept in touch with genetics until her death.36,37,45
that they caused cancers in humans. Deep-frozen biopsy
material was flown from Uganda to London, and after a The Call–Exner body, in the follicular cells of the
long series of failures a successful procedure for cultur- ovary, is named after Emma Call (1847–1937) (Fig. 6)
and Siegmund Exner.11 Call was one of the first women
ing Burkitt’s lymphoma tumor cells was evolved and a
new virus demonstrated by thin-section electron micros- physicians in the United States. She was born in
copy (it could not be demonstrated by any other tech- Massachusetts and studied medicine at the University of
nique). Dr. Barr left the team the year after the discovery Michigan, graduating in 1873. In response to a survey
when she married an Australian and has lived in conducted by the University of Michigan Alumnae
Am J Surg Pathol, Vol. 25, No. 10, 2001
4. ESSAYS IN MEDICAL EPONYMS 1329
to 1997. For 15 of those years she was the Director of the
Radiology Residency Programme, where that library
bears her name. It was during her residency at the
Massachusetts General Hospital, Boston, that she recog-
nized, with Dr. Cronkhite, a resident in Medicine, the
syndrome that bears their names.1 She also met her fu-
ture husband Jack Diner, who was studying medical il-
lustration. Dr. Diner successfully balanced her medical
career with motherhood, raising two sons and a daughter.
Since her retirement she has kept busy with volunteer
work, inter alia, teaching English and Hebrew. The
Diners also established the Wilma and Jack Diner
Student Art Acquisition Fund to support student artists.
She finds it amusing that she was once introduced at a
national radiology meeting as a pathologist (personal
communication, 1999).
Myrtelle Canavan (née Moore, 1879–1953) (Fig. 8)
was born in St. John’s, Michigan, and became the first
FIG. 6. Emma Call. Courtesy of Bentley Historical
Library, University of Michigan, Ann Arbor. woman neuropathologist in New England. In 1898 she
entered Michigan State College and the year after the
University of Michigan. She obtained her M.D. in 1905
Council, she wrote of her college days in 1924: “I en- from the Women’s Medical College of Pennsylvania,
tered the Medical Department of the University the first one of 36 women to graduate that year. Upon graduation
year that women were admitted. The first class of women she married a fellow doctor. In 1907 she became a labo-
15 in number were naturally the objects of much attrac- ratory assistant at the Danvers State Hospital in
tion critical or otherwise (especially critical) so that in Hawthorne, Massachusetts, where she subsequently be-
many ways it was quite an ordeal.” [Courtesy of the came Head of Laboratories, and where she met Elmer
Bentley Historical Library, University of Michigan.] As Ernest Southand, Professor of Neuropathology at
part of her postgraduate studies she went to Vienna and Harvard Medical School and Director of the Boston
studied the rabbit ovary with Siegmund Exner. She re- Psychiatric Hospital. This association was to foster her in-
turned to America and practiced at the New England terest in neuropathology, which led to many meticulous
Hospital for Women and Children from 1875 to 1917 as descriptions of brain and spinal cord pathology in a variety
an attending physician and consultant obstetrician.38 She of diseases.29 Among her 79 articles was the syndrome of
was the first woman to be admitted to the Massachusetts familial spongy degeneration in infants, to which her
Medical Society in 1884. This was the culmination of
what was called the “Ten year debate,” during which the
chief opponent of women’s membership, a Dr. W. W.
Wellington, held that women “were not fitted to practice
by reason of their sex characteristics.”47 She was also
active in church and philanthropic work for many years.
Her work on the ovary was her sole contribution to the
medical literature. Call–Exner bodies are also found in
granulosa cell tumors of the ovary, where they are pa-
thognomonic. When she died, she left no immediate
relatives.
A syndrome characterised by alopecia, nail dystrophy,
pigmentation, diffuse intestinal polyposis, protein-losing
enteropathy, osteomalacia, and malabsorption, 18 is
named after L. Cronkhite and Wilma Canada (Diner)
(Fig. 7). Wilma was born in West Virginia and raised in
Kentucky, where she was told that little girls did not
grow up to be doctors. She dispelled that myth by earn-
ing her medical degree from Duke University in 1950
and becoming a radiologist, serving on the staff of the
University of Arkansas for Medical Sciences from 1956 FIG. 7. Wilma Canada.
Am J Surg Pathol, Vol. 25, No. 10, 2001
5. 1330 A. G. ÖSTÖR
name was given.12 Although her paper might be criti-
cized for identifying her case as Schilder disease, it must
be remembered that each of Schilder’s four cases in his
original report was different and surely represented dif-
ferent disease processes (Raymond D. Adams, personal
communication, 2000). Despite extensive studies of
spongy degeneration of the nervous system, it was only
recently that a biochemical basis for this disorder has
been suggested.35 Another notable study reported on
1000 autopsy cases in institutionalized patients. In 1924
she became curator of the Warren Anatomical Museum
at Harvard University Medical School, a position she
held until her retirement. Dr. Canavan added hundreds of
neuropathologic specimens to the museum and also ini-
tiated various programs to effectively use the large ex-
hibit area. She concurrently was appointed Associate
Professor of Neuropathology at the Boston University
School of Medicine. She was highly respected in
the Boston community of neurologists. Canavan was FIG. 9. Erna Christensen. Portrait by Ingeborg Høyrup,
innovative, saw health care trends, and advocated co- painted for her 60th birthday, which now hangs in the
Neuropathology Laboratory of the Institute of Molecular
educational medical education. She died in Boston of
Pathology, University of Copenhagen, Copenhagen, Den-
Parkinson disease.
mark. Courtesy of Professor Folmer Elling.
Progressive infantile cerebral poliodystrophy was de-
scribed by Erna Christensen (1906–1967) (Fig. 9) and
K. H. Krabbe.13 She was born on the “smiling and lovely daughter, her character was distinguished by the tradi-
Danish island of Fyn.”44 She decided to become a doctor tional industriousness, solidity, and modesty of an old
rural family. She graduated from medical school in 1931,
at the age of 6 years when she was operated on for
her doctoral thesis being on subdural hematoma, re-
appendicitis at the Hospital Hyborg, and was taken care
garded as a classic in Danish medical literature. It was
of by an admired lady physician. It is ironic that her life
her rotation in neurosurgery that proved to be the begin-
ended in the same hospital from a malignant disease at
ning of her life work as a neuropathologist and neuro-
the comparatively early age of 61. Being a farmer’s
surgeon. One of her mentors was Dorothy Russell in
London. With her indefatigable application, her fine
skill, and her intuitive understanding, she contributed to
the many fields of neuropathology, attested to by her 99
publications on the subject. Being dually qualified, she
was skilled in clinicopathologic correlation. She had
firmly held views and demanded high standards from her
coworkers, but she was most demanding on herself. At
dinner parties in her beautiful home she was an amiable
hostess. Her good temper and good humor were highly
appreciated. During the summer of 1967 she suffered
metastases from a previously excised carcinoma of the
breast. Despite her knowledge of the nature of her ill-
ness, she strove to complete her preparations for the VIth
International Congress of Neuropathology, planned for
Copenhagen, of which she was the President, and in this
she persisted to within a few weeks before her death.44,46
In an obituary Van Bogaert writes: “None of us could
have suspected at the time that this lady, so so affable, so
vivacious and so full of good humor with a determination
for the Congress to be a success was already suffering
from a terminal illness”9 (author’s translation).
The cryopathic hemolytic syndrome14 was described
FIG. 8. Myrtelle Canavan. Courtesy of the Harvard Medi-
by the American hematologists Mildred Clough (née
cal Alumni.
Am J Surg Pathol, Vol. 25, No. 10, 2001
6. ESSAYS IN MEDICAL EPONYMS 1331
Clark, 1888–1938) and Ina Richter. Clough was born in
Newtonville, Massachusetts. After graduating from
Wellesley College with honors she obtained her MD
from the Johns Hopkins Medical School. As holder of
the Mary Putnam Jacobi Fellowship, Dr. Clough pub-
lished research, mostly in bacteriology, and later was
appointed instructor in medicine. Subsequently, she con-
tinued her work in the outpatient department and in pri-
vate practice. Ill health, however, had forced her to cur-
tail her work. She died of pneumonia and was interred in
her native Massachusetts. She was married to Dr. Paul
Clough, Associate Professor of Medicine at Hopkins,
and had two children. (Courtesy of the Alan Mason
Chesney Medical Archives of the Johns Hopkins
Medical Institution).
The metabolism of glycogen (the Cori cycle)15 and
glycogen storage diseases Types I and II16,17 were de-
scribed by Gerty Cori (née Radnitz, 1896–1957) (Fig.
10) and her husband Carl. She was born in Prague, the
FIG. 11. Marie Curie.
eldest of three sisters, her father having been the director
of a sugar company. She received her medical degree
they moved to Washington University in St. Louis: Carl
from the German University of Prague in 1920, the year
as Chairman of the Department of Pharmacology and
she married Carl, a fellow student. The association thus
Gerty as a research associate (a usually dead-end posi-
started was a lasting and happy one from the human
tion typically allotted to wife-assistants throughout the
point of view and, in terms of what it meant to science,
one of the most fruitful and successful on record.41 The scientific establishment). This collaboration nevertheless
elucidated the metabolism of glycogen and resulted in
Coris emigrated to the United States in 1922 to work at
the Nobel Prize in Medicine and Physiology in 1947 for
the New York State Institute for the Study of Malignant
the pair and Argentinian B. A. Houssay (being the third
Diseases, thus helping to initiate a great movement of
time this was awarded to a woman; see below). In the
scientists from the Old World to the New, in search of
same year she was abruptly promoted to Professor of
that freedom of teaching and research without which our
Biochemistry.43 Soon after she contracted myelofibrosis.
civilization will not survive. During this period Gerty
This, however, did not dampen her indomitable spirit,
and Carl were advised to end their research collaboration
and she went on to describe glycogen storage diseases,
because it would be detrimental to his career. In 1931
which was the first proof that a defect in an enzyme was
the cause of a human genetic disease.43 She died of renal
failure, never giving up work until the very end. Accord-
ing to Ochoa,40 “she was not only a scientist of enormous
stature but a human being of great spiritual depth, en-
dowed with the most precious gifts that can adorn human
nature. She was modest, kind, generous and affectionate
to a superlative degree and a lover of nature and art…”
Much has been written about the French Curie family,
two generations of which played a prominent role in the
development of modern chemistry and physics. It com-
prised Pierre and Marie Curie,33 their daughter Irène, and
her husband (Jean) Frédéric Joliot, all recipients of the
Nobel Prize. Suffice it to say Marie (1867–1934) (Fig.
11), born Mariya Sklodowska in Warsaw, Poland, is by
far the most famous woman scientist and the only
woman to have received the Nobel Prize twice, the first
for physics in 1903 (with Pierre and Henry Becquerel)
for their discovery of radioactivity by studying pitch-
blend in 1898.20 She received the second in chemistry in
FIG. 10. Gerty Cori. Courtesy of the Anderson Medical
1911, for her discovery of radium and polonium (the
Library, Washington University, St. Louis, MO.
Am J Surg Pathol, Vol. 25, No. 10, 2001
7. 1332 A. G. ÖSTÖR
latter named after her native country). She also became identifying the Streptococcus bacillus as the cause, de-
the first female professor at the Sorbonne. She was to- veloping a skin test, later known as the “Dick test” for
susceptibility or immunity,23 and developing a vaccine.
tally devastated after Pierre’s death (he died crossing a
road in Paris on a rainy day, when he slipped and fell As a result they received the prestigious Cameron Prize
under the wheels of a heavy horse-drawn wagon) when granted by the University of Edinburgh in 1933, given
she was only 42. Nevertheless, she went on with her “to a person who, in the course of the five years imme-
research while raising her two daughters in a generally diately preceding, has any highly important and valuable
hostile male-dominated scientific clique. The epic biog- addition to practical therapeutics.” The discovery of the
raphy (made into a TV series by the BBC in 1978), skin test unfortunately led to a long series of lawsuits
written by Eve, her other daughter,19 has made public her over their attempts to receive patents for their methods of
struggles for scientific recognition. Like many of the producing toxins and antitoxins (which some believe
early workers in radioactivity, Curie had no idea of the cost them the Nobel Prize), even though they were to
dangers of these penetrating rays to the body. She died of derive no personal gain. She was also active in child
leukemia, almost certainly brought on by prolonged ex- welfare and founded the Cradle Society in Evanston,
posure to the concentrated radioactivity of the ore she Illinois, one of the first medical professional organiza-
tions to facilitate the adoption of children39 (also, cour-
was purifying. The curie is a measure of radiation or
emission. tesy of the Alan Mason Chesney Medical Archives of the
In 1923 Gladys Dick (née Henry, 1881–1963) (Fig. Johns Hopkins Medical Institution).
12) was born in Pawnee City, Nebraska, daughter of a
banker/landowner/grain dealer. After taking her BS from
POSTSCRIPT
the University of Nebraska (1900), she overcame her
mother’s objections and attended Johns Hopkins Medical The author was delighted to hear from “Jane” of
School. Turning to biomedical research, specifically to Ophelia syndrome (see Part I). She writes: “I find it
blood chemistry, she went to the University of Chicago mildly amusing to be ‘immortal’ in the literature, but
(1911) where she met her future husband, George under a pseudonym and a literary reference. I hope it
Frederick Dick, who was working on the etiology of helps someone else’s family.” She goes on: “I hope you
scarlet fever. In 1914 the newly married Dicks joined realise that you’re one of a very few people who has ever
Chicago’s John R. McCormick Memorial Institute for got away with calling my Dad English. I suppose the
Infectious Diseases where she remained until her retire- equivalent slander in your part of the world is to mistake
ment in 1953. The Institute was founded with a grant a New Zealander for an Aussie!” (personal communica-
from John D. Rockefeller, who made the gift for research tion, 2000: he is Scottish). Mea culpa.
into scarlet fever after one of his grandsons died of the
disease. Working together, they made major contribu-
tions to the prevention and treatment of scarlet fever24 by Acknowledgments
The author thanks Miranda Francis, and Michael Watson
(the latter two having been inadvertently omitted from Part I)
for library assistance, Josephine Morrison for checking the ref-
erences, Virgil Fairbanks, MD, Robert Scully, MD, Thomas
Wright, MD, Robert Young, MD, Bert di Paola and Lloyd Ellis
for the photography.
ADDENDA
1. Cowden syndrome, which did not make the deadline
for Part I, is a rare autosomal dominant illness char-
acterized by mucocutaneous stigmata, colorectal pol-
yps, and an increased incidence of neoplasia in vari-
ous sites. It was named after Rachel Cowden, the
propositus.
Lloyd KM, Dennis M. Cowden’s disease: a pos-
sible new symptom complex with multiple system
involvement. Ann Intern Med 1963;58:136–42.
2. In this age of acronyms the following “synthetic” ep-
FIG. 12. Gladys Dick. Courtesy of the Alan Mason Ches-
onym was brought to my attention by my son, Andrew
ney Medical Archives of the Johns Hopkins Medical Insti-
James Östör, M.D.: Sapho syndrome (synovitis, acne,
tution, Baltimore, MD.
Am J Surg Pathol, Vol. 25, No. 10, 2001
8. ESSAYS IN MEDICAL EPONYMS 1333
19. Curie E. Madame Curie (tr. Sheean V). London: William Heine-
palmoplantar pustulosis, hyperostosis, and osteitis).
mann, 1938.
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poet, was celebrated throughout the ages for the beauty nue dans la pechblende. C R Acad Sci (Paris) 1898;127:
175–8,1215–7.
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21. Dacie JV. The life span of the red blood cell and circumstances of
from the Greek island where she lived (apropos, there is its premature death. In: Wintrobe MM, ed. Blood, Pure and Elo-
no evidence that she was a lesbian). quent. New York: McGraw-Hill, 1980:210–55.
22. Damrosch DS. Dorothy Hansine Andersen. J Pediatr 1964;65:
476–9.
23. Dick GF, Dick GH. A skin test for susceptibility to scarlet fever.
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