Names of medical syndromes fall off our tongues as we use them everyday. But who were the people who gave their names to them? Sammy Radstone looks into a few

Down's syndrome: John Langdon Haydon Down (1828-96)

John Down was born in Cornwall to an Irish-Cornish family in 1828. His scientific interest began as a child and progressed when he left school at the age of 13 to help his father in the pharmacy business. He moved to London at 18 to work as surgeon's assistant in Whitechapel. Down remained there for only a few months because he found work at the laboratories of the Pharmaceutical Society in Bloomsbury Square, London.

Down entered London Hospital Medical School at the age of 25. He excelled as a student and was predicted a brilliant career as a hospital doctor by his teachers. However, he surprised everyone by taking a post at the Earlswood Asylum for Idiots in Surrey in 1858. The next year Down was elected as an assistant doctor to the London Hospital and spent the next decade sharing his time between the two institutions.

Down's definitive monograph, Observations on an Ethnic Classification of Idiots, published in 1866, contained the classic description of the condition which now bears his name. He also described the vast improvements in speech and coordination that could be made if the children were given dedicated systematic training. Down believed the affected children to be part of the Mongolian race, being "examples of retrogression... of departure from one type [of race] and the assumption of the characteristics of another." This led to the condition being called "Mongolian idiocy." It was not until 1959 that the extra chromosome 21 was found to be the underlying abnormality, and in 1965 Mongolism was officially renamed as Down's syndrome.

L WILLATT, EAST ANGLIAN REGIONAL GENETICS SERVICES/SPL

Trisomy 21 of Down's syndrome

Many of Down's publications related to mental health, and he was an early protagonist for training those with learning difficulties. In 1868, Down moved to set up consultant practice in London and the next year established an institution at Teddington, called Normansfield, for training mentally retarded children of the wealthier classes.

Down had liberal views, was an advocate of higher education for women, and strongly disagreed with the popular supposition that this would make women likely to produce feeble minded offspring. He had a severe bout of influenza in 1890 and never recovered completely. One morning in 1896 at Normansfield, he collapsed at his breakfast and was dead 10 minutes later at his home in Hampton Wick.

Hodgkin's disease: Thomas Hodgkin (1798-1866)

Thomas Hodgkin was born into a strict Quaker family in 1798 in London. He received a broad private education, mainly from his father, which included the mastery of Latin, French, German, and Spanish. At the age of 21, Hodgkin began studying medicine at Guy's Hospital but transferred a year later to the University of Edinburgh, where he qualified in 1823.

Thomas Hodgkin

In 1925, Hodgkin was appointed lecturer in morbid anatomy and curator of the newly established pathology museum at Guy's Hospital Medical School. Within a short time, he had established a reputation as the leading pathologist of the time. In 1832 Hodgkin described the disease that now bears his name in a paper entitled On the Morbid Appearances of the Absorbent Glands and Spleen. Thirty two years later, another British physician, Samuel Wilks, described the same disease independently and with better precision. When Wilks later became aware of Hodgkin's work, he recognised its priority and named the condition Hodgkin's disease.

Hodgkin left Guy's Hospital in 1837, when he failed to be appointed as assistant doctor. This decision caused considerable controversy because Hodgkin was highly recognised for his clinical skills and for his role in establishing Guy's Hospital as an independent medical school of the highest quality.

Hodgkin began to withdraw from medicine and devoted more of his time to philanthropic works. He had a keen interest in the world beyond Europe, particularly in societies that were threatened with cultural extinction by the spread of European commercial, political, or cultural dominion. Hodgkin played a founding role in the Aborigines' Protection Society. In 1850 he married Sarah Frances Scaife, a widow, from Nottingham. The couple had no children of their own, but there were two sons from her first marriage.

In 1866 Hodgkin travelled to Palestine with his friend Moses Montefiore to help negotiate for better treatment for Jewish residents. While there, he was taken ill, and he died on 4 April. Sixty years after his death, his seven original histological preparations were re-examined for Hodgkin's disease. Only three actually had the condition; the remaining cases were of non-Hodgkin's lymphoma, tuberculosis, and other similar looking lymphatic diseases.

Parkinson's disease: James Parkinson (1755-1824)

James Parkinson was born in Shoreditch, London, on 11 April 1755. His father, John Parkinson, was an apothecary and a surgeon who practiced in Hoxton Square. James followed in his footsteps, being recognised as a surgeon by the Corporation of London in 1784. James eventually took over his father's practice. He married Mary Dale in 1781 and had four children.

Parkinson's early career was overshadowed by his involvement in numerous social and revolutionary causes. He advocated reform and representation of all people in the House of Commons and universal suffrage. He admitted to being a member of the London Corresponding Society for Reform of Parliamentary Representation, which was later charged with involvement in an alleged plot to assassinate King George III with a poisoned dart.

Parkinson published numerous small medical works including a work on gout, of which he was a sufferer, in 1895, and a report on a perforated and gangrenous appendix with peritonitis, in 1812. The latter is probably the earliest description of that condition in English medical literature.

WELLCOME LIBRARY, LONDON

House of famous scientists: James parkinson's house in Hoxton square

Parkinson's most important medical work was An Essay on the Shaking Palsy, published as a slim volume of 66 pages in 1817. In the short composition, Parkinson established the disease as a clinical entity and gave the classic clinical description of the illness: "Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to bend the trunk forward and to pass from a walking to a running pace; the senses and intellect being uninjured." Four decades later Jean-Martin Charcot added rigidity to Parkinson's clinical description, and named the syndrome Parkinson's disease

Parkinson was also a keen palaeontologist. He published many geological papers and cofounded the Geological Society of London. Another of his interests was health education of the public. James Parkinson died in Kingsland Road, London, on 21 December 1824. His son succeeded his profession at the Hoxton Square practice.

Krebs cycle: Sir Hans Adolf Krebs (1900-81)

Hans Adolf Krebs was born in Hildesheim, Germany, on 25 August 1900 of Jewish parents. His father was a successful ear, nose, and throat surgeon, and Hans followed his footsteps into medicine by studying at the universities of Göttingen, Freiburg, and Berlin. After one year at the Third Medical Clinic of the University of Berlin, he received his medical doctor's degree from the University of Hamburg in 1925. Krebs spent the next year working in the chemistry department at the Institute of Pathology in Berlin, where he learnt about the latest developments in biochemical research.

SPL

Hans Krebs

Krebs's research into metabolic cycles began in 1932 at the University of Freiburg. His work was temporarily halted in 1933, when the Nazi party put an end to his employment, and Krebs was forced to emigrate to England. He was invited to work at the School of Biochemistry at the University of Cambridge, under the Nobel prize winner Frederick Gowland Hopkins. In 1935, Krebs was appointed as a lecturer in pharmacology at the University of Sheffield, and later professor of the newly founded Department of Biochemistry.

During the war, Krebs worked in the field of nutrition, with particular attention to the roles of vitamins A and C. In 1954 he was appointed Whitley professor of biochemistry in the University of Oxford.

Throughout his time in Sheffield and Oxford, Krebs continued his research into cell metabolism. By 1937, Krebs was able to demonstrate the existence of a cycle of chemical reactions that combines the end product of sugar breakdown with oxaloacetic acid to form citric acid. He named the cycle the "citric acid cycle." Further investigations cumulated in 1957 with the definitive publication by Krebs and Kornberg of Energy Transformation in Living Matter. This showed that the citric acid cycle regenerated the oxaloacetic acid through a series of intermediate compounds while liberating carbon dioxide and electrons that are used immediately to form high energy phosphate bonds in the form of ATP.

The citric acid cycle became widely known as the Krebs cycle and was of vital importance to basic understanding of cell metabolism and molecular biology. Krebs was knighted for his work in 1958, and he died in Oxford on 22 November 1981.

Sammy Radstone final year medical student, University of Birmingham
Email: sammyradstone@hotmail.com

With thanks to Bob Arnott, director of the Centre for History of Medicine, University of Birmingham Medical School, for checking this article.

Further reading

• Firkin BG. Dictionary of medical eponyms. Carnforth: Parthenon, 1987.
• www.whonamedit.com