Series VI: Medical Sciences – SUPPLEMENT ... - Krongres

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A.D. ERDEMIR et al- Prof. dr. Hulusi Behcet (a famous Turkish physician) (1889-1948) and his 69 book on cutaneous leishmaniasis (oriental sore) reflective of the locale in which the specific protozoa is most commonly found, or in which it was first discovered. This famous physician mentioned that some drugs such as Neosalvarsan or carbonic acide couldn’t treat it. But, to Behçet, diathermy therapy was the best way. Behçet mentioned diathermy in every page of his book. To Behçet: “Diathermy method is applied in developed cities and good results are obtained. “Behçet treated some leishmaniasis cases with this way from 1920 to 1922. In this book, 4 cases are given. One of them was the son of a merchant from Adana. This patient was 19 years old and travelled to Syria for the trade occasionally. Ulcers were located on his right neck and these were combined in time and became in the size of silver coin (mecidiye). Other doctors couldn’t treat this patient. In this case, Hulusi Behçet determined Leishmania by preparing culture and diagnosed this disease as oriental sore. Moreover, in his book, Hulusi Behçet wrote that Dr. Resat Rıza and Mustafa Bakar prepared Leishmania Tropica cultures and this research was published in Gulhane Seririyatı Journal in German. In this first case, Hulusi Behçet examined microorganisms by ultramicroscope and saw flagellums. He informed about their dimensions. So, he applied diathermy to his patient. Hulusi Behcet accepted diathermy as the best therapy [3, 7, 9]. The second case of Hulusi Behçet was a servant girl. She was 23 years old. Oriental sore was seen on finger of right hand and left cheek. It was of a dull red colour and was inflammatory, quite tender and painful. Hulusi Behçet also diagnosed this case as oriental sore. In his third case, Hulusi Behçet treated a porter from Diyarbakır. He was 42 years old. Sore was on his right eyebrow and left cheek. The fourth case belonged to a girl. She came from Tahran to Istanbul. She was relative of Iran Emperor. A deep sore was on her right cheek. Behçet also treated this case with diathermy. Famous Turkish physician Behçet gave some knowledge about the discovery of microorganisms and their names. Behçet mentioned that American scholar .Wright named this disease’s microorganism as Helcosome tropicum at that time and R. Ross gave the name of Leishmania tropicum ou furonculose to it. But, afterwards, Leishmania Donovani was known as its microbe. Moreover, Behçet gave some knowledge about Leismania kinds in his small book: “Leishmanias are in two forms: Forms with flagellums and without flagellums. Two kinds of Leismanias are present. One of them is Leishmania Donovani and another is Leishmania tropica L. We also know Leishmania Americana. Leishmania Donovani also causes Kala-azar. Hulusi Behcet also gave other useful knowledge in his important book. Oriental Sore was seen in India, South Asia, Mediterrenean Sea Region, North Africa, Crete and Greek Islands, Adana etc. Oriental Sore was named Halep (Aleppo), Nile, Tahran, Isfahan, Palestine, Ankara and Diyarbakır sores. Hulusi Behçet mentioned epidemiology of this disease. Especially, Oriental Sore was infected from animals to dogs, monkeys, mouses. Hulusi Behçet also mentioned the characteristics of oriental sore. To Behçet: “On an average a fully developed Oriental sore is an inch or so in diameter. While there is often but one, there may be several or more distinct and sometimes quite widely separated formations. An Oriental Sore, when developed, is of a dull red colour, is usually of sluggish nature throughout its course, unless constantly knocked, irritated, or having added an active pyogenic factor, when it may become much more inflammatory, and quite tender and painful [4, 6, 12]. The favourite regions are the face, hands and
70 Bulletin of the Transilvania University of Bra�ov • Vol. 2 (51) - 2009 • <strong>Series</strong> <strong>VI</strong> forearms, and legs, but no part is exempt. Moreover, Behcet gave some knowledge about some ways used in oriental sore therapy. According to Behcet, arseno benzol and salvarsan couldn’t treat oriental sore. Neosalvarsan was good for syphilis. Famous physicians, Resad Rıza and Abdülkadir Bey accepted this condition. The best method was the diathermy [10]. This was an apparatus with electric. Namely, electric was applied to the sore. But this apparatus was present in the modern cities of Turkey at that time. To Behcet, in the other cities of Turkey, frozen carbonic acid was used for the therapy. But, he preferred diathermy therapy more than frozen carbonic acide. Hulusi Behcet applied diathermy by anaesthetizing his patients and the patient healed in ten or twenty days. So, he advised application of diathermy to every physician in his book. Hulusi Behcet gave a paper on nail sign of oriental sore in 1932 .M. Mayer and Ernst Nauck also accepted Behcet’s thoughts on this topic. Hulusi Behcet again mentioned these topics in his paper with the date of 1934 and named Two Important Points on Wright Sores (Wright Çıbanları Seririyatında �hmal Edilmi� �ki Mühim Nokta in Turkish). Approximately 350 million people in 8 countries are estimated to be under the threat of leishmaniasis. Most of the drugs used for the treatment of leishmaniasis are toxic and have many side effects. At present there is no vaccine against leishmaniasis. Vaccine development for parasitic infections is more difficult than for viruses and bacteria because of the antigenic complexity and parasitehost interactions [1, 2, 11]. References [1]. Abimelek. Cilt leischmaniose’ları hakkında münaka�a münasebetile. Deri Hast Frengi Kl Ar� 1934; 1: 283-284. [2]. Berberian DA. Cutaneous Leishmaniasis. Arch Dermat&Syph, 1944; 49: 433-435. [3]. Demirhan,E.A., Öncel,Ö.: Prof.Dr. Hulusi Behcet (A Famous Turkish Physician) (1888- 1948) and Behcet’s Disease from the Point of View of the History of Medicine and Some Results, ISHIM, 5(10):51-63 (2006). [4]. Forbes,M.A.: Exogenous Cutaneous Leishmaniasis Proved by Culture, Archives of Dermatology and Syphilology, 58( 3):301-307(1948). [5]. Hulusi Behçet. Haleb veya �ark Çıbanlarının Diyatermi ile Tedavisi. Dersaadet 1925 (�kinci Tab’ı) Kader Matbaası. [6]. Marinkelle, C.J.: The control of leishmaniases. Bull. WHO. 58: 807- 819, 1980. [7]. Mutlu S, Scully C.:The person behind the eponym: Hulusi Behcet (1889- 1948). J Oral Pathol Med. 1994 Aug; 23(7):289-90. [8]. Saylan T. Life Story of the Dr. Hulusi Behçet. Yonsei Med J 1997; 38: 327-332. [9]. �ehsuvaro�lu,B.N.: Yurdumuzda Deri Hastalıkları Tarihçesi, ve Muallim Dr.Hüseyin Hulki Beyden Bir Hatıra(History of Dermatology i,n Turkey), Deri Hastalıkları ve Frengi Ar�ivi, 3(8):462-504 (1966). [10]. Templeton HJ. Cutaneous Leishmaniasis Experimentally Produced. California& West. Med., 1941; 54:70-71. [11]. Turgay N. Leishmaniasis A�ı Çalı�malarında Son Geli�meler: Ne Zaman A�ılanabilece�iz? Türkiye Parazitoloji Dergisi, 29(4):232-234, 2005. [12]. Unat,E.K.: Leishmania’lar ve Leishmania’lı �nfeksiyonların Epidemiyolojisi Üzerine, Deri Hastalıkları ve Frengi Ar�ivi 5(15):869-880(1968). [13]. Yemni O. Ord. Prof. Dr. Hulusi Behçet. Deri Hast Frengi Ar� 1964; 1: 58-59.
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