Hepatic encephalopathy historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
wikipedia:The occurrence of disturbed behaviour in people with jaundice may have been described in antiquity by Hippocrates of Cos (ca. 460–370 BCE). Celsus and Galen (first and third century respectively) both recognised the condition. Many modern descriptions of the link between liver disease and neuropsychiatric symptoms were made in the eighteenth and nineteenth century; for instance, Giovanni Battista Morgagni (1682–1771) reported in 1761 that it was a progressive condition.
In the 1950s, several reports enumerated the numerous abnormalities reported previously, and confirmed the previously enunciated theory that metabolic impairment and portosystemic shunting are the underlying mechanism behind hepatic encephalopathy, and that the nitrogen-rich compounds originate from the intestine. Many of these studies were done by Professor Dame Sheila Sherlock (1918–2001), then at the Royal Postgraduate Medical School in London and subsequently at the Royal Free Hospital. The same group investigated protein restriction and neomycin.
The West Haven classification was formulated by Prof Harold Conn (1925–2011) and colleagues at Yale University while investigating the therapeutic efficacy of lactulose.
Overview
Historical Perspective
Discovery
- [Disease name] was first discovered by GB. Morgagni, an italian anatomist, in the 18th century who described a case of hepatic encephalopathy. He reported the history of a noble from Venice who was an alcohol misuser in the past. The patient first developed ascites and some episodes of agitation, and then he developed prolonged episodes of somnolence and delirium.
- Friedrich Theodor von Frerichs, in the 19th century clearly reported the existence of episodes of delirium, somnolence and coma in liver disease in his famous treatise on liver disease.
- In 1954, Dame Sheila Patricia Violet Sherlock and her disciples in London gave a definite improvement in the description of the clinical findings, the pathophysiology and treatment of hepatic encephalopathy. For the first time she confirmed the role of hyperammonaemia in the pathophysiology of the hepatic encephalopathy and the role of gut microbiota that could be modulated by antibiotics to revert coma.
Outbreaks
Landmark Events in the Development of Treatment Strategies
- In 1954, [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].
Impact on Cultural History
Famous Cases
- The following are a few famous cases of disease name: