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- MEDICAL MILESTONES
-
- By ANNE MULLENS
- Vancouver Sun
-
- VANCOUVER - There is little debate that Canada's most famous
- contribution to medicine was the discovery of insulin in 1921-22.
-
- The historic breakthrough made Frederick Banting and Charles Best
- household names, earned Banting and advisor J.J.R. Macleod the 1923
- Nobel Prize in medicine, and saved the lives of millions of
- diabetics worldwide.
-
- See <20health> for a discussion of research funding crunch
- See <18health> for a discussion of technician shortage
-
- But insulin is far from being the only significant Canadian medical
- achievement over the years.
-
- Other personalities, discoveries and inventions sprinkle the
- history of Canadian medicine.
-
- Although not a definitive list, some notable landmarks follow:
-
- - SIR WILLIAM OSLER: Born in Ontario in 1849, Osler rose to
- become one of the world's most respected and renowned physicians,
- teaching and practising in Canada, the U.S. and England.
-
- ``He was the most brilliant and influential medical teacher of his
- day,'' says his biographer Harvey Cushing.
-
- Although he made many medical observations, he is remembered mostly
- for his technique of bedside teaching, which was adopted by medical
- schools around the world, and his text, The Principles and
- Practices of Medicine (1892), which was translated into four
- languages and remained a standard western medical text until the
- late 1950s.
-
- - PABLUM: In the late 1920s, three doctors at Toronto's Hospital
- for Sick Children - Frederick Tisdall, Alan Brown and T.G.H. Drake
- - came up with the formula for the first vitamin enriched, pre-
- cooked cereal as a way to combat the scores of malnourished
- children they saw admitted to hospital.
-
- Pablum is now a staple of infant feeding around the world.
-
- - HEPARIN: Although discovered in 1916 by a young student
- researcher at Johns Hopkins University in the U.S., the blood
- thinner heparin sat unused until it was purified under a team at
- University of Toronto's Connaught Laboratories, directed by insulin
- co-discoverer Charles Best.
-
- Toronto surgeon Dr. Gordon Murray pioneered the animal and human
- research of the extract, purified from beef lungs and pork
- intestines, to establish its safe and effective use to prevent
- clotting.
-
- The use of heparin opened the door to heart surgery, renal dialysis
- and the treatment of blood clotting disorders.
-
- - NORMAN BETHUNE: Born in Gravenhurst, Ont. and trained at the
- University of Toronto, the hero of Communist China organized the
- first blood transfusion service in the world in Madrid during the
- Spanish civil war.
-
- He went to China in 1938 to help the guerrilla army, organizing the
- first mobile hospital unit there and training schools for nurses
- and medical assistants.
-
- He died of blood poisoning contracted during an operation in 1939.
-
- - ELECTRON MICROSCOPE: Using the theory and crude model
- developed by German engineer Ernst Ruska, University of Toronto
- physicists James Hillier and Albert Prebus built a much-improved
- electron microscope in 1937 that magnified 7,000 times.
-
- Their design became the forerunner of all electron microscopes,
- which now magnify 200,000 times and make visible the most intimate
- details of cells, tissues, viruses and micro-organisms.
-
- - WILDER PENFIELD: A world-renowned neurosurgeon, the U.S.-born
- Penfield (1891-1976) was a professor of neurology and neurosurgery
- at McGill, where he founded the Montreal Neurological Institute.
-
- His systematic mapping of the human brain earned him world
- attention, as did his development of an operation for epilepsy.
-
- ``Starting with Penfield and the MNI, a standard of excellence in
- neurological sciences developed in Canada that continues to this
- day,'' said Dr. Pierre Bois, president of the Medical Research
- Council.
-
- - BARR BODY: University of Western Ontario researcher Murray
- Barr was the first to identify the female sex nucleus of a cell,
- named the Barr body in his honor.
-
- Barr and graduate student Ewart Graham found that only the cells
- from female cats had a mass of chromatin, or genetic material,
- called sex chromatin.
-
- The 1942 discovery helped determine genetic abnormalities and
- chromosomal disorders.
-
- - CURARE: While performing an appendectomy on a young man in
- 1942, Montreal anesthetist Dr. Harold Griffith became the first
- doctor to use the South American arrow poison, curare, during an
- operation.
-
- The drug, which causes temporary paralysis by interfering with
- nerve impulses, enables doctors to work on relaxed muscles, to use
- less anesthetic and to reduce anesthetic complications.
-
- Derivatives of curare are used in operations to this day.
-
- - HYPOTHERMIA: In the early 1950s Dr. William Bigelow of the
- Toronto General Hospital developed the technique in heart surgery
- of gradually lowering a patient's temperature to slow their
- metabolism and reduce their need for blood.
-
- It enabled blood flow to the heart to be stopped for eight to 10
- minutes, allowing a bloodless, clear field of vision to operate on
- the heart, paving the way for a range of heart repairs.
-
- Hypothermia is now combined with heart-lung machines that oxygenate
- blood outside the body and has enabled surgeons to operate on the
- heart for hours without damage to the tissue.
-
- - VINCA ALKALOIDS: In the 1950s a research team led Dr. Robert
- Noble, then at the University of Western Ontario, discovered that
- extracts from the leaves of the Jamaican periwinkle plant, Vinca
- rosea, stopped the growth of cancerous cells.
-
- The compounds, called vinca alkaloids, were the first Canadian
- contributions to chemotherapy and have dramatically improved the
- cure rate of Hodgkins and non-Hodgkins lumphoma, and childhood
- leukemia.
-
- - CARDIAC PACEMAKER: Toronto General Hospital scientists, along
- with researchers at Ottawa's National Research Council, designed
- and demonstrated the effective human use of the first cardiac
- pacemaker in the 1950s.
-
- Too large to be implanted under the skin, the devices did not
- become practical until the transistor was refined 10 years later in
- the U.S.
-
- - ENDOCRINE HORMONES: Canadians have isolated a number of
- important hormones over the years. Biochemist J.B. Collip, who
- purified insulin for Banting and Best, went on to later isolate a
- hormone from the parathyroid, called parathormone, which raises
- blood calcium levels.
-
- Collip did extensive work on reproductive hormones secreted from
- the pituitary and was also the first to isolate the hormone ACTH
- (adrenocorticotrophic hormone) from the adrenal glands.
-
- Montreal endocrinologist Dr. Jacques Genest demonstrated the role
- of the hormone aldosterone in high blood pressure in the 1950s.
-
- In 1962, University of B.C. researcher Harold Copp isolated the
- hormone calcitonin, produced by the thyroid and parathyroids, which
- lowers blood calcium. University of Manitoba physiologist Dr. Henry
- Friesen, while at McGill, isolated and purified human prolactin,
- which stimulates milk production and can be a major cause of
- infertility.
-
- In 1981, Queen's University biochemist Dr. Aldopho de Bold
- isolated the heart hormone, atrial natriuretic factor (ANF), which
- naturally lowers blood pressure.
-
- - ``BLUE BABY OPERATION:'' Until a surgeon at the Toronto Sick
- Children's Hospital developed a technique to repair ``transposition
- of the great vessels'' of the heart, infants with this
- malformation, who were blue from the lack of oxygenation of their
- blood, usually died a few months after birth.
-
- Dr. Bill Mustard decided to reroute the blood flow between the
- chambers inside the heart by taking a piece of tissue from the
- tough sack around the heart and building a baffle between the left
- and right atrium of the heart to reverse the blood flow.
-
- Said Mustard of the first few minutes after operating on the first
- patient, Maria, in 1963: ``We could hardly believe it, the blue
- child turned a beautiful pink right before our eyes.''
-
- Now called the ``Mustard procedure,'' the operation has become the
- standard correction for the heart defect and is performed around
- the world.
-
- - LUNG TRANSPLANTS: The world's first successful single lung
- transplant was performed at the Toronto General Hospital in 1983 by
- Drs. F.G. Pearson and Joel Cooper.
-
- The world's first successful double lung transplant was performed
- at the same hospital in 1986 by Dr. Alex Patterson.
-
- The first successful double lung transplant on a patient with
- cystic fibrosis followed there in 1988.
-
- - GENETICS: Canada has developed an international reputation for
- high-calibre genetics research. In the last five years, genetic
- researchers at the Hospital for Sick Children and the University of
- Toronto have made enormous strides in pinpointing genes that cause
- hereditary diseases.
-
- In 1987, Drs. Ronald Worton and Peter Ray identified a portion of
- the gene for Duchenne muscular dystrophy; in 1988 Drs. Roy Gravel
- and Don Mahuran identified one of the key enzyme defects that cause
- Tay Sachs disease; and in 1989 Drs. Lap-Chee Tsui and Jack Riordan,
- along with Dr. Francis Collins at the University of Michigan,
- discovered the gene for cystic fibrosis.
-
- All the discoveries open the door for greater understanding of the
- disease, and the potential for drug treatments or prenatal
- diagnosis.
-
-
-