MUMPS ORCHITIS IN THE WORLD WARS

Vol. 179, No. 4, Supplement, Monday, May 19, 2008

North America. Masturbation and subsequent semen loss were seen as serious causes of wasting in Victorian American and Europe. This fear led to a variety of interventions, some more Draconian than others, to prevent this feared complication. Although much more rare, variants of both conditions have also been reported in women (koro as phobic fear that the breasts and/or vulva are receding and dhat as excessive vaginal discharge.) Both conditions have been reported to occur in an epidemic fashion, even recently. In 1967 two cases of koro were linked to eating SRUNYDFFLQDWHGDJDLQVWVZLQHÀXZKLFKOHGWRDZLGHVSUHDGSDQLFDQG hundreds of cases of the disorder in Singapore. In 2003, an outbreak of public hysteria over alleged malicious magical penis shrinking occurred in Senegal and led to several deaths from vigilante violence. CONCLUSIONS: Phobic anxiety about damage to/loss of the genitalia has been reported throughout history and in men from all corners of the world. On occasion, socio-cultural factors have led to widespread “penis panics” affecting entire populations. Source of Funding: None

901 THE GREAT PLAGUE – PANDEMICS CAN CHANGE HISTORY Monika H Frank, Friedrich H Moll*, Joachim Leissner, Klaus Bergdolt. Cologne, Germany. INTRODUCTION AND OBJECTIVE: In the modern imagination the plague remains the formost example of the scourge of epidemic disease.The Black Death-bubonic plague with complications¿UVWQRWHGLQ$VLDLQZDVWKHJUHDWHVWPHGLFDOGLVDVWHURIWKH0LGGOH Ages and one of the most deadly pandemics in human history. After an appearent absence of six centuries, the Black Death returned. It kills in LWV¿UVWZDYHSHUKDSVSHUFHQWRI(XURSH¶VSRSXODWLRQHVWLPDWHGDW 75 million people.The city of Florence e. g. lost almost three-quarters of its population between 1347-1447, most Italien cities lost close to a third of their population.The Black Death differed from earlier epidemics in its extend and its ubiquity and provoked the development of several new models, which were to endure for several centuries and served as a reminder of the fragility of life. Plague was to become the central epidemiological regulator.It disrupted economic, cultural and social life for a very long time. Faced with this huge challenge the authorities took action, particular in the Italian cities and decided to protect health by regulations.The pillars of government sanitary regulation were inspection RI WUDYHOOHUV TXDUDQWLQH RI VKLSV DQG OD]DUHWWRV HQFORVHG SODFHV IRU quarantining individuals.Witnessing the disaster this led to new piety of WKHVRFLHW\DQGWRF\QLFLVPWRZDUGUHOLJLRXVRI¿FLDOV'HDWKZDVVHHQ in a new and more naturalistic view, death now represents itsselve as the great social leveler in the dance macabre illustrations. The theme of the Apocalypse became a source of inspiration. Collective aggressions occured directed toward marginated populations like beggars, lepers and the Jews.Violence against the Jews was heightened by the epidemic but had occured before. All this were indicators for the turn of a new era. Church authorities proclaimed mass intercessions and propritiatory prayers.Saint Anthony and Saint Sebastian were invoked against epidemics.Witchcraft became a bone of contention between the medical and religious outlooks. METHODS: Local sources of the history of the Great Plague of the City of Cologne were compared with original sources within the literature in a hermeneutical manner. RESULTS: The magnitude of the Black Death provides a striking demonstration of just how powerful a force disease can be in history. The Great Plague belonged to early modern times and to the daily life of society. CONCLUSIONS: Epidemics are powerful factors in human history and can be important for changes in politics, economics, culture and society. As the real factor in history they were often underestimated. Source of Funding: None

902 MUMPS ORCHITIS IN THE WORLD WARS William P Conners*. Albany, NY. INTRODUCTION AND OBJECTIVE: Mumps orchitis, while rarely seen today in developed countries, has greatly impacted the

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military throughout history, and notably in both World Wars I & II. In these FRPEDWWKHDWHUVWKRXJKWKHGLVHDVHVDZVLJQL¿FDQWDGYDQFHPHQWLQ understanding and treatment. 0(7+2'60XOWLSOHUHVRXUFHVZHUHXWLOL]HGLQFOXGLQJZHE based literature search involving Medline, PubMed, as well as urology, virology, and infectious disease texts. RESULTS: In the 5thFHQWXU\%&+LSSRFUDWHV¿UVWGHVFULEHG mumps orchitis in adolescdent wrestlers in the first book of the Epidemics. Later, Guillaume de Baillou acknowledged a local epidemic in Paris during the French Wars of Religion in the 16th century. In World :DU,WKHQXPEHURIPXPSVFDVHVDGPLWWHGWRWKHKRVSLWDORUFRQ¿QHG WRTXDUWHUVZDV7KLVLQFLGHQFHZDVRQO\VXUSDVVHGE\LQÀXHQ]D and gonococcal infection. Lost man days from duty during World War I amounted to 3,884,147 days. In all wars including World War II, the main problem resulting from mumps outbreaks has been the length of time lost from duty following the complication of orchitis. Mumps has a relatively long incubation period and slow mode of transmission, which prolonged the outbreaks, and seriously interfered with active-duty performance. At Camp McCoy, during World War I, orchidotomy was performed in severe cases of epididymo-orchitis. The prevailing thought regarding WKLVRSHUDWLRQDWWKHWLPHZDVWKDWWKHLQFLVLRQRIWKH¿UPHQFDSVXODWLQJ WXQLFDDOEXJLQHDPD\KDYHSUHYHQWHGVWHULOL]DWLRQRIRQHRUERWKWHVWLFOHV in severe cases. Given that bilateral epididymo-orchitis occurred in 10.6% of those with this complication, orchidotomy was used to relieve pain UDWKHUWKDQWRSUHYHQWFRPSOHWHVWHULOL]DWLRQ7KHFRQFHSWRIPXPSVZDV revised following the demonstration of transmission of mumps by salivary ÀXLGWRMacacus rhesus monkey by Johnson and Goodpasture in 1934. ,Q-RKQ)(QGHUVDQ$PHULFDQPLFURELRORJLVWGHYHORSHGWKH¿UVW vaccine. Initially delivered to troops in WWII, this vaccine, based on a killed virus, was only moderately and temporarily successful. CONCLUSIONS: As a result of this reserach, serological and skin tests used to diagnose mumps were soon developed. This paved the way for Dr. Maurice Hillman who developed the Jeryl Lynn strain of the mumps vaccine from the mumps virus that infected his 5year old daughter. As part of the MMR vaccine, it was approved for use by the FDA in 1967. Today, live mumps virus vaccines derived from this strain are responsible for the low incidence of mumps orchitis seen in our troops, and the world, today. Source of Funding: None

903 GODFREY HOUNSFIELD AND THE DEVELOPMENT OF COMPUTED TOMOGRAPHY (CT) Shikohe Masood*, Daben Dawam, Tahir R Bhat, Pardeep Kumar, Gulzar Mufti. Gillingham, United Kingdom. INTRODUCTION AND OBJECTIVE: CT is widely used in all disciplines of Medicine, including Urology. Sir Godfrey Newbold +RXQV¿HOG GHYHORSHG WKLV LPDJLQJ PRGDOLW\ ZKLFK LV QRZ LQWHJUDO WR medical diagnosis and treatment. METHODS: A systematic search of online and published material was conducted including original articles and papers. 5(68/76 +RXQV¿HOG ZDV ERUQ LQ D YLOODJH QHDU 1HZDUN Nottinghamshire, England. He spent much time on his own on his father’s farm where he developed an interest in engineering whilst building sound recorders, radio sets and water powered rockets. The concept of the CT scanner was borne during a weekend ramble in the country when he realised that “you could determine what was in a box by taking readings at all angles through it”. His employer at the time, (OHFWULFDODQG0XVLFDO,QGXVWULHV(0, UHLQYHVWHGVRPHRIWKHSUR¿WV IURPSURPRWLQJ7KH%HDWOHVLQWKHGHYHORSPHQWRI+RXQV¿HOG¶VLQLWLDO LGHDV+RXQV¿HOGFROODERUDWHGZLWK-DPHV$PEURVHDQHXURUDGLRORJLVW at Atkinson Morley’s Hospital London. Beginning with weak gamma ray source which took nine days to complete the scan, he then used X-rays and shortened the scanning time to nine hours. The initial CT scans were performed on preserved human brains obtained from local hospital PXVHXPKRZHYHUWKHLPDJHVZHUHGLVWRUWHGE\SUHVHUYDWLRQLQIRUPDOLQ so he experimented on bullock’s brains which he used to bring to the laboratory in a bucket while traveling on London buses. These images were also blurred because stunning the cow before slaughtering resulted in presence of blood in the ventricles. This problem was solved when .RVKHUNLOOHGERYLQHEUDLQVZHUHXVHG7KH¿UVWOLYHSDWLHQWWREHVFDQQHG