Pituitrin

Pituitrin

Amongst the Medical Collections in the HSTM Museum is a small cardboard box which contains a dozen very small glass vials, 3 tiny blades and a piece of paper addressed to “The medical professional”. These vials contain shots of the “extract of the posterior lobe of the pituitary gland” or “Pituitrin” to use its trade name.

Pituitrin was registered as a trade name in 1908 by Parke, Davis & Co. an American drugs company based in Detroit, Michegan. Parke, Davis and Co. was one of America’s oldest pharmaceutical companies, founded in 1867 and adopting the name “Parke, Davis and Co.” in 1871. Parke, Davis and Co. was one of (if not the first) companies in the United States to have a dedicated pharmaceutical research laboratory building . The company continued to operate until 1970 when it was bought by Warner-Lambert, it was then acquired by Pfizer in 2000.

Although registered to Parke, Davis and Co. this particular sample of Putuitrin was manufactured in Middlesex on 15 September 1948 with a use by date of 14 September 1950. It is a “Physiologically Standard” sample of “One dozen ‘Glaeptic’ Ampoules. 0.5cc (5 International Oxytocic Units)”. Interestingly the blades in the box are not mentioned on the packaging, but are presumably to remove the glass seal before the patient was given a deep intramuscular injection of Pituitrin (by a medical professional).

The Accompanying leaflet tells us that:
“‘Pituitrin’ contracts the arteries and arterioles and causes an increase in blood pressure that is accompanied by slowing of the pulse. If is of value for raising the blood-pressure in the treatment of patients suffering from shock and acute illness.
Owing to its stimulating effect upon atonic non-striated muscle, ‘Pituitrin’ is employed in cases of uterine inertia, ischuria paradoxa, the ischuria of labour, intestinal distension after abdominal operations, and to disperse gas in the colon before radiography. ‘Pituitrin relieves many cases of urinary tension following labour or gynaecological operations; it is also useful in cases of enuresis due to atony of the sphincter of the bladder. In cases of diabetes insipidus, the subcutaneous injection of ‘Pituitrin’ has greatly diminished the polyuria. ‘Pituitrin’ is the product of choice in the control of post-partum Haemorrhage.”

Extract of the posterior lobe of the pituitary gland contains, according to a Dr. O. Leyton, at least two useful hormones; oxytocin and vasopressin. Oxytocin is in Pituitrin and effects the abdomen and uterus, but not blood vessels. Vasopressin affects blood vessels and thus increases blood pressure but has no effect on the uterus . The most common use of extract of the posterior lobe of the pituitary gland was Oxytocin particularly in post-partum (post natal) haemorrhaging as suggested by the accompanying note to our sample, it was particularly useful following a caesarean section. Oxytocin could also be used to induce contractions during labour. This box of Pituitrin-Oxytocin probably belonged to a midwife or the midwifery department here at Leeds.

Although the brand name “Pituitrin” is no longer used a synthetic version of Oxytocin called “Syntocinon” in still used in difficult births. The hormone is the subject of much research as it appears to be hugely influential in human interactions and responses; research includes oxytocin’s effects on child birth, parental bonding, romantic attachment, sexual-arousal, interaction with addictive drugs, memory, trust and autism.

The Pituitrin is currently in the Philosophy Foyer in the Michael Sadler Building as part of the new display “Liquid Remedies; drugs, dosages and delivery”.

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24th May Education Event and Tour of Old Medical School

Monday the 24^th of May saw the first in a series of school workshops to be hosted this summer by the museum. Around 15 children travelled up from Newham in London to take part in a three day stay at Leeds University that kicked off with the museum’s Victorian surgery workshop followed by a tour of the Old Medical School. The kids, who were in years ten and eleven and in the process of completing their GCSEs, had been selected as the ‘gifted and talented’ students from their respective year groups and invited to take part in this scheme.

Laura led for the first section of the workshop (a presentation about Victorian amputation) and Kiara led for the second section, ably assisted by Claire, Sue, Liz, Lawrence, Becky, and myself. The students could have been forgiven for being a bit tired after an early start and a long coach trip up from London but were instantly engaged by Laura’s ebullient delivery and were quick to answer the questions that were put to them during the presentation.

The kids also responded very well to the second section of the workshop which required them to try and deduce the uses of certain objects from our medicine collection by looking only at the object itself. Within just a few minutes (we were a bit pushed for time as the group had arrived a bit late) almost all of the groups were able to make an accurate assessment of what the object would have been used for and give strong reasons for their judgments.

Plaque outside the Old Medical School.

Next it was on to the tour of the Old Medical School. After the short walk down from the Gillinson Room through the LGI and into the Old Medical School the school group and volunteers were greeted by our enthusiastic tour guide John.

The Old Medical School was opened in 1894 and operated as the site for the Medical School until as recently as 1977, when the new Worsley Medical building was opened. The building was designed by W.H. Thorp, who was also responsible for the Leeds City Art Gallery, and had many features that would have been considered technologically advanced around the turn of the twentieth-century; such as electric lighting, natural roof lighting in lecture theatres and dissecting rooms, and an ingenious steam-powered heating and ventilation system.

Old Medical School.

Our tour started in the hexagonal Entrance Hall, where John pointed out the various crests of associated medical and educational institutions that adorn the walls, the Medical School’s Latin motto (which translates as ‘Heal the sick, cleanse the lepers; freely have you received, freely give’) and the stair set from which the medical students’ results would have been publicly announced.

We then moved into the Library, a splendid wood-panelled room, which is now occupied by laboratory benches and a presentation area, but was originally used as a study area for the students of the Medical School, as well as for degree ceremonies and even as a ballroom. On display in the Library are some interesting objects from the Medical School’s past, which could well be worthy of further investigation. Next, we went up to the first floor of the building and into The Anatomy Lecture Theatre, a steep amphitheatre-like room with a large roof light designed for illuminating the dissections that would have taken place in front of the medical students.

Dissecting Room, 1895.

After this we ventured past the old dissecting room and up to the hexagonal meeting room at the top of the building. Here John told us of his successful search for evidence of a tunnel leading from the crypt of St. George’s Church directly to the basement of The Old Medical School. We then descended through the rest of the building, seeing the room in which cadavers used to be stored prior to dissection, before going into the courtyard and leaving through the gate where hearses once delivered the bodies for the use of the Medical School.

The whole afternoon was a success, especially considering it was the first time that the workshop has been held since Easter, and the tour was an interesting opportunity to see the building in which much of Leeds’ recent medical history was written, and for which thanks must go to John. The students who had travelled up from London were engaged and interested throughout both the tour and the workshop and hopefully it will encourage some of them to consider doing a degree in HPS at Leeds University and possibly even join the ranks of the museum’s volunteer team.

Sources:

All information on the history of the Old Medical School taken from Bill Mathie’s excellent pamphlet entitled: A Brief Tour of the Old Medical School.

Photos from (in order):

http://www.flickr.com/photos/27550874@N03/3716518616/

http://www.leeds.ac.uk/ymdhs/

http://www.heritage-explorer.co.uk/web/he/searchdetail.aspx?id=9958&crit=medicine

 

 

Hidden Histories: Pathology

by Kiara White and Laura Sellers

Pathologists study the causes and effects of diseases, with the aim of improving diagnostics. The Pathology collection at the University of Leeds includes pathological specimens, wax models, microscope slides, illustrations and photographic glass plate slides. These were all important for teaching and research within the University, the Leeds General Infirmary and the wider pathology community.

The pathological specimen currently featured in Hidden Histories is a trichobezoar; a compact masses of hair that forms in the gastric cavity. They are the result of a psychological condition called trichophagia, a psychological disorder which drives suffers to compulsively consume hair. The first description of these is thought to have been in 1779, but there are still few accounts in psychiatric literature (Santos, 2012, p43). This example was removed from the stomach of a teenage girl, c.1930. The patient had become severely underweight, as the hair had filled her stomach completely, meaning there was no room left for food, and so surgical removal was required.

It is displayed in front of X-ray and photographic images (date unknown) relating to another patient who compulsively ingested metal pins. Surgeons removed a total of 1188 pins that had accumulated in the patient’s stomach. These images were taken from glass plate negatives, which were used to store and make copies of images. Glass plates were once a common photographic medium, but declined in popularity over the early decades of the 20th century, superseded by flexible film.

Also on display are two pathological illustrations by Miss Ethel M. Wright, selected from the collection of approximately 50 of her works held by the museum, dating from the 1900’s to the 1950’s. We have been unable to establish where Ethel was employed, but she produced numerous illustrations for distinguished scientists, including the surgeon Lord Berkeley Lloyd Moyniham and the pathologist Professor Matthew Stewart, both of whom worked at the University of Leeds and the Leeds General Infirmary.

Illustrations like these were used to communicate knowledge between scientists and from professors to students, in books, journal articles and lectures. Those in our collection all relate to Matthew Stewart (1885-1956), who was Professor of Pathology at the University of Leeds between 1918 and 1951 and editor of the Journal of Pathology and Bacteriology, from 1934 to 1956. Stewart was also devoted to the Institute of Pathology’s Charles Brotherton museum, in the Algernon Firth building. (Various, 1956, p.1054) He gained a reputation as a highly knowledgeable morbid anatomist and histologist, and correspondence from the collection shows that his expert diagnostic opinion was often sought by other pathologists struggling with difficult cases.

The examples were have chosen here nicely illustrate this, as well as the value of such illustrations in sharing pathological knowledge. The first shows a case of malignant spheno-occipital chordoma. A chordoma is a rare form of slow-growing tumour that can occur at the base of the skull or along the spine. In this case the tumour is situated at the joint between the spine (spheno) and base of the skull (occipital). The patient was a 30 year old male, an ex-soldier who had suffered from phosgene gas poisoning in 1917. He was admitted to hospital in 1921, having suffered for the past three years with symptoms including headaches, sight problems, muscle weakness and loss of balance, and died the following month. The tumour, about the size of a hen’s egg, had caused damage such as the stretching and flattening of the optic nerves. This case is described as being both pathologically and histologically (microscopically) characteristic, but it is thought to have been only the seventeenth case ever recorded, and the first record published in the British Isles. (Burrow and Stewart, 1923)

The second illustrates a case of myeloid sarcoma in the radius of the left forearm of a six year old girl, admitted to the Leeds General Infirmary in March, 1922 with a swelling that had been first noticed three years before. After examining a portion of the tumour, it was decided that the arm should be amputated, and the girl recovered successfully. Bone tumours were one of Stewart’s specialisms, and this case is significant because of certain unusual features. A maroon colour to at least part of the tumour was commonly held to the most characteristic feature of myeloid sarcomas, to the extent that most surgeons would regard this as diagnostic. This tumour however, was to the eye “not at all like the usual appearance of a myeloid sarcoma”; it was white throughout. However, “the microscopic characters were quite unmistakable” as a case of myeloid sarcoma. It was because of the rare feature that Stewart felt this account required “a full and adequately illustrated case report.” (Stewart, 1923)

In addition to their ability to communicate essential diagnostic knowledge, these illustrations draw our attention to the historical links between art and science and in particular the interdisciplinary nature of art and medicine, especially before advancements in photography. The illustrator was required and able to draw an accurate representation of the object or specimen in front of them but also needed an informed approach in order to draw attention to specific details of that case. This, it could be argued, moved illustrations from purely anatomical to pathological.

There are varied opinions on when medicine and medical illustration became fully intertwined, but there is evidence as far back as the ancient Greeks, though Da Vinci and Vesalius are hailed as the early-modern experts. It appears that many were either medical or artistic and then had to learn the other skill (Donald, 1986). Modern medical illustrators are required to complete specialist training that combines both of these areas. We do not yet know what training Ethel Wright undertook in order to produce the illustrations displayed.

References
Burrow, J.Le.F., and Stewart, M.J., “Malignant Spheno-Occipital Chordoma”, The Journal of Neurology and Psychopathology, Vol. IV., No. 15, 1923, pp.205-217
Donald, G., “The history of medical illustration”, Journal of Audiovisual Media in Medicine, 9, 1986, pp.44-49
Santos, T. et al, “Trichophagia and Trichobezoar: Case Report”, Clinical Practice & Epidemiology in Mental Health, 8, 2012, pp.43-45
Stewart, M.J., “Large Myeloid (Myeloma) of the Radius in which the tumour is white throughout”, The British Journal of Surgery, Vol. 10, Issue 39, 1923, pp.322-325
Various Authors, “Obituary; Matthew John Stewart, C.B.E., M.B., LL.D. Glasg., Hon. M.D. Melb., F.R.C.P., F.R.F.P.S.”, The Lancet, Nov. 17, 1956, pp. 1054-1055

Hidden histories update

Thanks everyone who came to the meeting on Wednesday, and I look forward to your posts on your chosen objects.  For those of you not there, this is what we discussed and decided, more or less.

All together we now have at least 9 objects for the case: 2 from physics (and possibly another from maths), 2 from botany/ biology/ herbarium, 1 from history of education, 1 from medicine, 1 from English, pieces from the Newlyn-Philips machine and the Astbury camera.  The plan is now for each person who chose an object to tell us about it in 4 main ways: by talking about it on camera for 1 minute, writing a catalogue entry, writing c.500wds on it on the blog and later putting this on the website linked to the catalogue entry.  And finally to reduce all that to a 30wd label for the case.

Everyone seemed pretty happy with the Hidden Histories theme, each pleasingly interpreting this theme in a different way.  The theme can be taken to mean hidden objects and collections but also hidden stories and the hidden history of the university, which it was generally felt, is not celebrated at Leeds as much as at other universities, but is interesting and a potential selling point of Leeds university.

That’s all, please watch out for (or write and post) information on all the objects so far chosen for the case.