Philip Hench Shouolter (Hench Philip Showalter)

February 28, 1896, Mr.. - March 30, 1965
American doctor Shouolter Philip Hench was born in Pittsburgh (Pennsylvania), the son of John Clare (Shouolter) Hench and Jacob Bikslera Hench, a philologist and teacher. After completion of primary education in the Academy Sheydisayd and University of Pittsburgh School of X. in 1912. enrolled at Lafayette College in Easton. After 4 years he earned a Bachelor of Arts, after which he was enrolled in medical school at the University of Pittsburgh. Received in 1920. medical degree, he worked for a year as a doctor-intern at the hospital of St.. Francis in Pittsburgh. In 1921, Mr.. H. was adopted by a graduate student in medical school at the University of Minnesota in Rochester. Here, he and 1923. he became an assistant in 1925. - Member of scientific associations and in 1926. - Chief doctor in the department of rheumatic diseases.
During the 1928/29 academic r. H. investigated accompanying rheumatic fever with Ludwig Aschoff in Freiburg University, and with Friedrich von Muller of the Ludwig Maximilians University in Munich. Upon returning to Rochester, he began the study of diagnosis and treatment of rheumatic diseases, particularly rheumatoid arthritis. First described in medical literature in the middle of the XIX century., Rheumatoid arthritis is a chronic disease characterized by systemic lesions of connective tissue, mainly in the locomotor apparatus. Most commonly affects the joints of the fingers, hands, wrists and ankle, and joints of the spine. The inflammatory process not only causes pain but can also lead to permanent deformation of the joints. Patients with severe disease bedridden. There have been cases of spontaneous remission, but they are extremely rare, and the beginning of medical practice, X. no satisfactory treatment results have been found.
In April 1929,. 65-year-old patient with severe rheumatoid arthritis told H. that during the recently postponed his jaundice decreased pain in the joints and range of motion in them increased. Jaundice - a painful condition characterized by yellow coloring of the skin, mucous membranes, sclera of eyes, which is associated with the accumulation of bilirubin in the blood and its deposition in tissues. Bilirubin, a breakdown product of hemoglobin, transports oxygen in red blood cells, is metabolized and excreted by the liver. The most frequent causes of jaundice are cirrhosis, hepatitis and other liver and gall bladder. Over the next five years, X. and his colleague Charles Slocum observed similar remission of rheumatoid arthritis during the development of jaundice in 16 patients. Moreover, X. observed that the severity of symptoms and improve joint function directly comparable with the severity of jaundice. Based on these observations, he concluded that an unknown substance (which he called the substance X) in patients with jaundice and rheumatoid arthritis is remission of rheumatoid arthritis. In 1934, Mr.. He and Slocum published the results of their observations, pointing to the existence of a correlation between jaundice and symptoms of rheumatoid arthritis, weakening and assuming the existence of substance X.
Trying to cause a remission of disease, X. has tested several methods of therapeutic treatment for patients with rheumatoid arthritis. With his colleagues, he compared the effectiveness of oral administration of bile, blood transfusion from donors with jaundice, intravenous administration of bilirubin and other methods, but none of them did not give the desired results. The researchers noticed that women suffering from rheumatoid arthritis, remission of the disease often occur during pregnancy with subsequent exacerbations in the postpartum period. In 1938. H. Slocum and reported their observations of the pregnancy of 20 women with rheumatoid arthritis, . by concluding, . that remission, . associated with jaundice and pregnancy, . presuppose the existence of an unknown substance X, . is' no bilirubin, . a direct female sex hormones. ",
. Biochemist Edward K
. Kendall, who conducted the study in Mayo Clinic, isolated in 1914. hormone from the thyroid tissue. In 30-ies. Kendall went on to obtain and the identification of adrenal hormones, which are located above the upper pole of both kidneys and consist of the outer cortex and inner medulla. In the marrow is synthesized and secreted into the bloodstream adrenaline (epifedrin). Adrenalin, a potential stimulant of the sympathetic nervous system, increases blood pressure and has a cardiotonic action, uchaschaya rhythm of heart rate and increasing the oxidation processes.
. The cells of the cortex of adrenal glands that synthesize and secrete adrenal hormones in the bloodstream is controlled by adrenocorticotropic hormone (ACTH), secreted in the pituitary gland
. At a low level of hydrocortisone in the blood sekteriruet pituitary ACTH, which in turn stimulates the synthesis and secretion of hydrocortisone by cells of the cortical substance of the adrenals. At a high level of hydrocortisone in the blood of the formation of ACTH in the pituitary gland decreases, resulting in decreased production of this hormone in the adrenal. Among the distinguished corticosteroids: glucocorticoids (cortisone and hydrocortisone), involved in the metabolism of carbohydrates, fats and proteins, and mineralkortikoidy involved in the regulation of water and electrolyte balance. Cortisone and hydrocortisone blocks the biochemical reactions associated with the inflammatory response to tissue damage or infection.
In 30-ies. H. and Kendall began to consider the possibility of treating patients with rheumatoid arthritis with corticosteroids, but it took more than 10 years before these substances have become available for clinical use. In 1941, when Kendall was involved in organization of priority programs for the mass production of corticosteroids in order to use them for the army during World War II, X. after one of the conference made such a mark in his notebook: 'Feel the substance E (cortisone) in rheumatoid arthritis'.
In 1942, Mr.. H. was promoted to lieutenant-colonel of medical service, becoming its chief and director of the Army Center for the Study of rheumatism in the naval hospital. After the war, X. - Army civilian consultant Surgery Center. Along with Slocum X. published a review on the connection jaundice and pregnancy with a decrease in symptoms in patients with rheumatoid arthritis. In this article, they noted that symptomatic improvement sometimes occurs after general anesthesia during surgery. The researchers used a general anesthesia suffer from rheumatoid arthritis and received some positive effect, . and jaundice caused by a number of patients by introducing laktofenina, . that likewise has reduced symptoms of rheumatoid arthritis.,
. In August 1948
. H. Slocum and treated patients with severe rheumatoid arthritis laktofeninom to develop her jaundice and reduce symptoms of disease. However, the treatment was ineffective, and in September they began to introduce it by intramuscular injection of cortisone (in the form of a suspension of crystals in saline) to 100 mg daily. H. later recalled that 'within three days of patient's condition was much improved and continued to improve up until the daily dose of cortisone is not decreased to 25 mg'. This was the first clinical evidence of therapeutic efficacy of corticosteroids in rheumatoid arthritis. The next year, X. and Slocum entered the pituitary hormone ACTH, the patient with rheumatoid arthritis and also found it effective in the treatment of disease. Soon found, . that after the interruption of the reception of any of these drugs re-relapse symptoms of rheumatoid arthritis, . and the use of cortisone and ACTH is associated with the appearance of side effects, . including increased blood pressure, . blood glucose and a specific form of obesity with preferential deposition of fat on the abdomen and back of the neck.,
. H
. and Kendall received the Nobel Prize in Physiology or Medicine 1950 g. 'for discoveries concerning hormones of the adrenal cortex, their structure and biological effects'. They shared the award with Tadeusz Reichstein (Polish-Swiss chemist, who, regardless of their isolated and identified the hormones of the adrenal cortex). In a speech at the presentation Goran Liliestrand of the Karolinska Institute has predicted "a new era in the treatment of [rheumatoid arthritis,] belonging to a group of diseases that ... considered the most severe and difficult to treat '.
In 1927, Mr.. H. married Mary Genevieve Kahler; they were born two sons and two daughters. Considered the leading expert in the treatment of yellow fever, X. interested in the history of medicine and wrote several articles on the subject. He enjoys photography, tennis, loved the opera and the stories of Arthur Conan milked.
X. died in 1965. in the state of Anne-Wei (Jamaica) during the rest of the Caribbean Sea.
X Awards. included the Albert Lasker Award of the American national community health (1949) and the prize for Medicine Foundation Passau Passau (1951). He was an honorary member of the American Medical Association and American College of Physicians, one of the founders of the American Society of Rheumatologists and an honorary member of the Royal Society of Medicine in London. He was awarded honorary degrees from Lafayette College, University of Western Reserve (now - Case-Western Reserve) and the University of Pittsburgh.