- Email: [email protected]
The person behind the name: part 2
SPECIAL CONTRIBUTION J Oral Maxillofac Surg 61:1212-1215, 2003
The Person Behind the Name: Part 2 Shahid R. Aziz, DMD, MD* What we are today, as oral and maxillofacial surgeons and residents, is often taken for granted. However, it is important to remember our history, the development of our tremendous specialty, and the men and women who helped to shape it. A basic knowledge of where we came from creates the foundation for a stronger future. The following is the sequel to a similar article published in 1997 that reviewed some of the prominent names in oral and maxillofacial surgery.1
Stenson’s Duct The parotid duct is named after the 17th century anatomist Niels Stenson (1638-1686). Stenson was born in Copenhagen and educated at its university. Born a Lutheran, during his university years he converted to Catholicism and was later named Bishop of Tritiopolis. While at the University of Copenhagen, Stenson was an avid student of religion, geology, and anatomy, under the direction of a well known physician, Thomas Bartholin (famous for his description and treatment of the vaginal cyst that bears his name). Inspired by his studies, Stenson completed his university education and furthered his studies in Amsterdam, working with the anatomist Blasius. During the dissection of a sheep’s head, Stenson first came across the parotid duct. Although initially discounted by Blasius as an aberration, Stenson proved the existence of bilateral parotid ducts through the dissection of multiple human cadavers. The Dutch anatomist Von Horne, who named the parotidduct after Stenson, later immortalized his discovery. As his career progressed, Stenson conducted dissections on the human eye, central nervous system, ovaries, aorta, and heart. He was the first to identify the congenital cardiac defect today known as tetrology of Fallot.2
*Assistant Professor, Department of Oral and Maxillofacial Surgery, UMDNJ—New Jersey Dental School, Newark, NJ. Address correspondence and reprint requests to Dr Aziz: Department of Oral and Maxillofacial Surgery, UMDNJ—New Jersey Dental School, 110 Bergen St, Room B854, Newark, NJ 07103; e-mail: [email protected] © 2003 American Association of Oral and Maxillofacial Surgeons
0278-2391/03/6110-0018$30.00/0 doi:10.1016/S0278-2391(03)00685-2
Wharton’s Duct The submandibular duct is named after another 17th century anatomist, Thomas Wharton (16141673). Wharton was born in Winston-on-Tees, England, and educated at Britain’s 2 ancient seats of higher learning, Oxford and Cambridge. Like Stenson, Wharton’s finding was influenced by the work of Bartholin—it was Bartholin’s initially studies of the oral cavity that led Wharton to pursue and discover the submandibular duct. Among Wharton’s other notable accomplishments are being the private tutor to the illegitimate son of the Earl of Sunderland and physician to King Charles II guards during the Great Plague in London.3
Bell’s Palsy The facial nerve palsy is named after Sir Charles Bell (1774-1842), noted English surgeon, neuroanatomist, and artist. Bell was born in Edinburgh, Scotland, the son of an Episcopal clergyman. Five years after his birth, his father died suddenly, leaving his mother to raise him. Bell studied medicine at the University of Edinburgh. While a medical student, he published and illustrated an anatomy text, “A System of Dissection,” in 1798. After graduating from medical school, Bell and his elder brother John, also a physician and anatomist, opened a private school of anatomy in Edinburgh. A year later, he was elected to the Royal College of Surgeons, Edinburgh. Bell left Edinburgh in 1804 to pursue his medical career in London. He lectured extensively on anatomy and conducted research elucidating the anatomy of the central nervous system. He published multiple texts, including “A New Idea of the Anatomy of the Brain and Nervous System,” in which he noted the distinction between sensory and motor nerves, being the first to do so. In addition, Bell described the pathways of the fifth and seventh cranial nerves. In 1812, Bell became surgeon at Middlesex Hospital and founded its medical school. He also at this time served as a military surgeon. His studies of gunshot wounds to the face combined with his animal experiments led Bell to the correct conclusion that cranial nerve VII controls the muscles of facial expression. Bell named the facial nerve “the respiratory nerve of the face” and described its functions “in all the exhilarating emo-
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tions, the eyebrows, eyelids, the nostrils and angle of the mouth are raised. In the depressing passions it is reverse.”4 For his research into the central nervous system, Bell was knighted in 1831. He returned to Edinburgh to become chair of surgery. Bell died at the age of 68 from coronary artery disease.5
Yankauer Suction This suction tip commonly used in oral surgery and otolaryngology is named after Dr Sidney Yankauer. Born in New York City in 1872, he was educated at City College of New York and received his medical degree from Columbia University College of Physicians and Surgeons. He went on to train in otolaryngology at Mount Sinai Hospital in New York, where he spent his career. In addition to the suction that bears his name, Yankauer developed multiple surgical instruments, including a pharyngeal speculum for direct examination of the eustachian tube, an electrode for fulgurating the larynx, and a radium needle for the endoscope. He died at the age of 60 on August 26, 1932, of heart failure.6
Seldin Periosteal Elevator The Seldin elevator is named after Dr Harry M. Seldin (Fig 1). Born in Russia, Seldin immigrated to America as a child with his family. He received his dental degree from New York University in 1918, followed by service in the United States Naval Dental Corps. Early in his career he showed a keen interest in Anesthesia, joining the New York University dental faculty in 1926 as chief of the Department of General Anesthesia until 1931. He published the premier dental anesthesia text of its day, “Practical Anesthesia for Dental and Oral Surgery,” in 1934. Seldin’s contributions to the field of oral surgery were extensive. He was on staff at several New York City hospitals, including Bellevue and Harlem Hospitals, and served as director of the Division of Dentistry, New York City Department of Hospitals (currently known as the New York City Health and Hospital Corporation). Seldin also served on the American Board of Oral Surgery and was president of the American Society of Oral Surgeons in 1956. Seldin was also the recipient of numerous awards: he was an honorary member of 15 foreign dental societies and honorary professor of oral surgery at several universities. His most lasting legacy perhaps is the dental school he helped found at Hebrew University in Israel. In 1964, the Harry M. Seldin Center for Oral and Maxillofacial Surgery was founded at Rambam Government Hospital in Haifa. Seldin died on January 8, 1975.7
FIGURE 1. Dr Harry M. Seldin (courtesy of Dr R. David Seldin)
Sjo ¨gren’s Syndrome Sjo ¨ gren’s syndrome is the triad of symptoms that includes xerophthalmia, xerostomia, and a connective tissue disorder, usually rheumatoid arthritis. A similar entity, sicca syndrome, which involves xerostomia and xerophthalmia only, is commonly referred to as Sjo ¨ gren’s syndrome as well. Both were first elucidated by Henrik Sjo ¨ gren (1899-1986). Sjo ¨ gren was born in the Swedish town of Koping. He studied medicine at Karolinska Institute in Stockholm, graduating in 1927. Three years later, while an ophthalmology resident in Stockholm, he published a report in Hygiea, the proceedings of the Swedish Medical Association, describing a female patient with severe arthritis and extreme dryness of the eyes and mouth. His intellectual curiosity aroused, Sjo ¨ gren embarked on a PhD thesis, focusing on this disease. Over the next 3 years, he examined 19 cases, all women, aged 29 to 72 years. In 1933, he defended his thesis “Zur Kenntnis der Keratoconjunctivitis Sicca.” He detailed his corneal findings in these patients, specifically epithelial defects in the lower part of the cornea, as well as conjunctival ulcerations. His thesis, however, was
1214 found to be average, receiving the grade of 1.5 on a scale of 1 to 3. This did not allow him to be awarded the title “Docent,” a prerequisite to enter academia. He subsequently moved in 1936 to Jonkoping, Sweden, where he was superintendent of the first ophthalmology unit at the county hospital. It was there that he developed techniques of corneal transplantation. For his significant contributions to medicine, Sjo ¨ gren was awarded the Docent title from the University of Gothenburg in 1957 and was made a full professor in 1961. In 1976, at the age of 77, he was made an honorary member of the Swedish Rheumatology Society and presided over the first international symposium on Sjo ¨ gren’s syndrome, held in Stockholm. Sjo ¨ gren died in September 1986 from complications of a stroke.8,9
Rowe’s Maxillary Disimpaction Forceps The Rowe Maxillary Disimpaction forceps, used to mobilize the down fractured maxilla, is named after one of the giants in British oral and maxillofacial surgery, Normal Lester Rowe (1915-1991). Rowe was born in Gloucestershire, England, and educated at Malvern College, and received his dental degree from Guy’s Hospital Dental College, University of London in 1937. He then entered the British Army Dental Corps at the rank of captain and served during World War II. Rowe’s interest in maxillofacial trauma developed from his wartime experience, particularly his experience in the frontline casualty unit in Normandy immediately after D-Day. After the war, he received his oral surgery training in London and was appointed consultant in oral and maxillofacial surgery at Rooksdowne House, Basingstoke, Kent, where he came under the influence of the legendary Sir Harold Gillies. At Rooksdowne House he cultivated his interest in facial trauma as well as developing his skills in all aspects of oral surgery. At the same time he also completed medical school, again at Guy’s Hospital. As a dual-degree oral surgeon, Rowe became one of the first dental specialists to qualify for the Royal College of Surgeons. In the 1950s, British oral surgery was a fledgling field. Rowe took a leadership role in developing the specialty, establishing multiple maxillofacial clinics in numerous hospitals throughout England. Highlights of his long and illustrious career include completing the first maxillary osteotomy in the United Kingdom with Gillies in 1950, publishing the landmark text “Fractures of the Facial Skeleton” in 1955 with H.C. Killey, publishing the 2-volume “Maxillofacial Injuries” in 1985, and founding the British Association of Oral Surgeons. Public recognition of his profession achievements came in 1976, when he was awarded
PERSON BEHIND THE NAME
by Queen Elizabeth II the Commander of the Order of the British Empire.10-12
Le Fort Fractures Rene Le Fort (1869-1951) will forever be associated with the midfacial fractures he classified more than 100 years ago. He was born in Lille, France, to a medical family— his uncle was Leon Le Fort, a distinguished anatomist and surgeon of the era. At age 19, while in military school, he placed first in the medical school entrance examinations of the “Internat des Hopitaux de Lille” and was awarded his medical degree at age 21, being the youngest physician in France at that time. He subsequently trained as a military surgeon at the army hospital “Val-de-Grace” in Paris until 1899. In 1900 he conducted experiments on fresh cadavers, resulting in the publication of 3 papers in 1901 in “Revue de Chirurgie,” documenting his classification of the Le Fort fractures of the facial skeleton. Interestingly, a popular misconception is that Le Fort dropped human skulls off of buildings or dropped cannon balls on the skulls as part of his experiments. In reality, Le Fort’s methodology in his experiments was much simpler— he struck the cadaver heads with a club, a kick, or a vice, or struck the head against a table, in an organized and precise fashion, documenting how each facial bone reacted to blows of different degrees of force. In 1902, Le Fort returned to Lille to teach in the medical school. He remained there until 1912, when he rejoined the French army during the Balkan War to practice battlefield surgery. Two years later, at the outbreak of the Great War, Le Fort again became a frontline surgeon. He was cited for operating under dangerous conditions at the frontlines during the Battle of Dinant. At the end of the World War I, he returned to Lille as professor of operative medicine, children’s surgery, and orthopedics. He spent the remainder of his career in Lille. Le Fort passed away in 1951 at the age of 82.13,14
Dingman Mouth Gag The Dingman mouth gag is an essential part of cleft palate surgery, allowing for maximum access/visibility of the surgical field. It is named after Reed O. Dingman (1906-1985). Dingman was born in Rockwood, Michigan. He received his dental degree from the University of Michigan followed by a master’s degree/residency in oral surgery. Dingman was certified by the American Board of Oral and Maxillofacial Surgery in 1940 and subsequently became assistant professor of oral surgery at University of Michigan. During this time Dingman published a significant paper on the treatment of mandibular prognathism via
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mandibular body osteotomy.15 He also completed medical school at the University of Michigan, followed by surgical and plastic surgical training at Michigan and Barnes Hospital in St Louis. The American Board of Plastic Surgery certified him in 1949. From 1948 to 1952, Dingman served as editor of the Journal of Oral Surgery. Ultimately, Dingman developed the section of plastic surgery at the University of Michigan, serving as chairman of the division until 1976. He also was intimately involved with the American Society of Maxillofacial Surgeons (ASMS). Dingman passed away at age 79 in December 1985.16 Although his origins were in dentistry and oral surgery, Dingman ultimately challenged the role of oral surgery. At the 1953 meeting of the American Society of Plastic Surgeons, Dingman presented a resolution to limit oral surgery’s scope of practice. Although initially rejected, Dingman again presented this resolution, now infamously known as the Dingman Resolution, to the ASMS. It was subsequently passed and the resolution was sent to the chief of surgery in every hospital in America, which in turn created difficulty for oral surgeons on a local level. Ultimately Dingman’s actions became a rallying point for American oral surgery, whose forthright action paved the way for the exceptional quality of training and privileges achieved by today’s oral and maxillofacial surgeon for the benefit of the public.17
Ludwig’s Angina Ludwig’s angina (bilateral submandibular and submental space infection) is perhaps one of only a handful of truly life-threatening emergencies faced by the oral and maxillofacial surgeon. It is named after Dr Wilhelm Frederick von Ludwig (1790-1865), the German physician who first described this deadly fascial space infection. Born outside of Stuttgart, Ludwig studied medicine at the University of Tubingen, receiving his medical degree in 1811. Napoleon’s attempted conquest of Russia forced Ludwig into the German Army (an ally of Napoleon at the time) as a medical officer. He commanded the Wurtetemberg field hospital in Smolensk. Ludwig was subsequently captured by the Russian Army and became the personal physician to a Russian countess in southern Russia. He was freed in 1814 when Germany’s King
Frederick I broke his allegiance with France and allied with Russia. Ludwig spent the next 50 years becoming one of Germany’s most repected physicians. In 1836 he presented a paper describing a fast-spreading infection involving the floor of the mouth and into the neck. Ludwig noted that this was almost invariably a fatal affliction secondary to airway obstruction. Ludwig died in 1865 at the age of 75. Ironically, his obituary noted that Ludwig succumbed to “an inflammation of the neck. . . . Which boded the worst. . .he lost his life suddenly with out any immediate warning.”18 Whether this was a Ludwig’s angina or not remains unclear.19
References 1. Aziz SR: The person behind the name. J Oral Maxillofac Surg 55:847, 1997 2. Welton TS: Biographical brevities: Stenson’s duct. Am J Surg 14:501, 1931 3. Wooden W, Erlen J, Futrell J: History of the salivary glands, in Granick M (ed): Management of Salivary Gland Lesions. Philadelphia, PA, Lippincott, 1991, pp xv-xix 4. Pearce J: Sir Charles Bell. J Neurol. Neurosurg Psychiatry 56: 913, 1993 5. Brian V: The man behind the name: Sir Charles Bell. Nursing Times 73:420, 1977 6. Obituary: Sidney Yankaur. Ann Otolaryngol 41:1268, 1932 7. Harry M. Seldin, oral surgeon dead at 79. N Y State Dent J 41:146, 1975 8. Wolheim F: Henrik Sjogren and Sjogren’s syndrome. Scand J Rheum 61:11, 1986 (suppl) 9. Mutlu S, Scully C: The person behind the eponym: Henrik Sjogren. J Oral Pathol Med 22:439, 1993 10. Levignac J: A tribute to the late Mr. Norman Rowe CBE. Br J Oral Maxillofac Surg 30:337, 1992 11. Blenkinsopp P: Obituary NL Rowe. BMJ 303:1056, 1992 12. Obituary: Norman Lester Rowe. Br Dent J 171:226, 1991 13. Tessier P: The classic reprint. Experimental study of fractures of the upper jaw. Rene LeFort MD. Plast Reconstr Surg 50:600, 1972 14. Patterson R: The Le Fort Fractures: Rene Le Fort and his work in anatomical pathology. Can J Surg 34:183, 1991 15. Dingman RO: Osteotomy for correction of mandibular malrelationship of developmental origin. J Oral Surg 2:239, 1944 16. Millard R: Reed O. Dingman MD. Plast Reconstr Surg 78:445, 1986 17. The Building of a Specialty: Oral and Maxillofacial Surgery in the United States 1918-1998. J Oral Maxillofac Surg 56:110, 1998 (suppl 3) 18. Burke J: Angina Ludovici: A translation, together with a biography of Wilhelm Frederick von Ludwig. Bull Hist Med 7:1115, 1939 19. Murphy S: The person behind the eponym: Wilhelm Frederick von Ludwig. J Oral Pathol Med 25:513, 1996
The Person Behind the Name: Part 2 Shahid R. Aziz, DMD, MD* What we are today, as oral and maxillofacial surgeons and residents, is often taken for granted. However, it is important to remember our history, the development of our tremendous specialty, and the men and women who helped to shape it. A basic knowledge of where we came from creates the foundation for a stronger future. The following is the sequel to a similar article published in 1997 that reviewed some of the prominent names in oral and maxillofacial surgery.1
Stenson’s Duct The parotid duct is named after the 17th century anatomist Niels Stenson (1638-1686). Stenson was born in Copenhagen and educated at its university. Born a Lutheran, during his university years he converted to Catholicism and was later named Bishop of Tritiopolis. While at the University of Copenhagen, Stenson was an avid student of religion, geology, and anatomy, under the direction of a well known physician, Thomas Bartholin (famous for his description and treatment of the vaginal cyst that bears his name). Inspired by his studies, Stenson completed his university education and furthered his studies in Amsterdam, working with the anatomist Blasius. During the dissection of a sheep’s head, Stenson first came across the parotid duct. Although initially discounted by Blasius as an aberration, Stenson proved the existence of bilateral parotid ducts through the dissection of multiple human cadavers. The Dutch anatomist Von Horne, who named the parotidduct after Stenson, later immortalized his discovery. As his career progressed, Stenson conducted dissections on the human eye, central nervous system, ovaries, aorta, and heart. He was the first to identify the congenital cardiac defect today known as tetrology of Fallot.2
*Assistant Professor, Department of Oral and Maxillofacial Surgery, UMDNJ—New Jersey Dental School, Newark, NJ. Address correspondence and reprint requests to Dr Aziz: Department of Oral and Maxillofacial Surgery, UMDNJ—New Jersey Dental School, 110 Bergen St, Room B854, Newark, NJ 07103; e-mail: [email protected] © 2003 American Association of Oral and Maxillofacial Surgeons
0278-2391/03/6110-0018$30.00/0 doi:10.1016/S0278-2391(03)00685-2
Wharton’s Duct The submandibular duct is named after another 17th century anatomist, Thomas Wharton (16141673). Wharton was born in Winston-on-Tees, England, and educated at Britain’s 2 ancient seats of higher learning, Oxford and Cambridge. Like Stenson, Wharton’s finding was influenced by the work of Bartholin—it was Bartholin’s initially studies of the oral cavity that led Wharton to pursue and discover the submandibular duct. Among Wharton’s other notable accomplishments are being the private tutor to the illegitimate son of the Earl of Sunderland and physician to King Charles II guards during the Great Plague in London.3
Bell’s Palsy The facial nerve palsy is named after Sir Charles Bell (1774-1842), noted English surgeon, neuroanatomist, and artist. Bell was born in Edinburgh, Scotland, the son of an Episcopal clergyman. Five years after his birth, his father died suddenly, leaving his mother to raise him. Bell studied medicine at the University of Edinburgh. While a medical student, he published and illustrated an anatomy text, “A System of Dissection,” in 1798. After graduating from medical school, Bell and his elder brother John, also a physician and anatomist, opened a private school of anatomy in Edinburgh. A year later, he was elected to the Royal College of Surgeons, Edinburgh. Bell left Edinburgh in 1804 to pursue his medical career in London. He lectured extensively on anatomy and conducted research elucidating the anatomy of the central nervous system. He published multiple texts, including “A New Idea of the Anatomy of the Brain and Nervous System,” in which he noted the distinction between sensory and motor nerves, being the first to do so. In addition, Bell described the pathways of the fifth and seventh cranial nerves. In 1812, Bell became surgeon at Middlesex Hospital and founded its medical school. He also at this time served as a military surgeon. His studies of gunshot wounds to the face combined with his animal experiments led Bell to the correct conclusion that cranial nerve VII controls the muscles of facial expression. Bell named the facial nerve “the respiratory nerve of the face” and described its functions “in all the exhilarating emo-
1212
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tions, the eyebrows, eyelids, the nostrils and angle of the mouth are raised. In the depressing passions it is reverse.”4 For his research into the central nervous system, Bell was knighted in 1831. He returned to Edinburgh to become chair of surgery. Bell died at the age of 68 from coronary artery disease.5
Yankauer Suction This suction tip commonly used in oral surgery and otolaryngology is named after Dr Sidney Yankauer. Born in New York City in 1872, he was educated at City College of New York and received his medical degree from Columbia University College of Physicians and Surgeons. He went on to train in otolaryngology at Mount Sinai Hospital in New York, where he spent his career. In addition to the suction that bears his name, Yankauer developed multiple surgical instruments, including a pharyngeal speculum for direct examination of the eustachian tube, an electrode for fulgurating the larynx, and a radium needle for the endoscope. He died at the age of 60 on August 26, 1932, of heart failure.6
Seldin Periosteal Elevator The Seldin elevator is named after Dr Harry M. Seldin (Fig 1). Born in Russia, Seldin immigrated to America as a child with his family. He received his dental degree from New York University in 1918, followed by service in the United States Naval Dental Corps. Early in his career he showed a keen interest in Anesthesia, joining the New York University dental faculty in 1926 as chief of the Department of General Anesthesia until 1931. He published the premier dental anesthesia text of its day, “Practical Anesthesia for Dental and Oral Surgery,” in 1934. Seldin’s contributions to the field of oral surgery were extensive. He was on staff at several New York City hospitals, including Bellevue and Harlem Hospitals, and served as director of the Division of Dentistry, New York City Department of Hospitals (currently known as the New York City Health and Hospital Corporation). Seldin also served on the American Board of Oral Surgery and was president of the American Society of Oral Surgeons in 1956. Seldin was also the recipient of numerous awards: he was an honorary member of 15 foreign dental societies and honorary professor of oral surgery at several universities. His most lasting legacy perhaps is the dental school he helped found at Hebrew University in Israel. In 1964, the Harry M. Seldin Center for Oral and Maxillofacial Surgery was founded at Rambam Government Hospital in Haifa. Seldin died on January 8, 1975.7
FIGURE 1. Dr Harry M. Seldin (courtesy of Dr R. David Seldin)
Sjo ¨gren’s Syndrome Sjo ¨ gren’s syndrome is the triad of symptoms that includes xerophthalmia, xerostomia, and a connective tissue disorder, usually rheumatoid arthritis. A similar entity, sicca syndrome, which involves xerostomia and xerophthalmia only, is commonly referred to as Sjo ¨ gren’s syndrome as well. Both were first elucidated by Henrik Sjo ¨ gren (1899-1986). Sjo ¨ gren was born in the Swedish town of Koping. He studied medicine at Karolinska Institute in Stockholm, graduating in 1927. Three years later, while an ophthalmology resident in Stockholm, he published a report in Hygiea, the proceedings of the Swedish Medical Association, describing a female patient with severe arthritis and extreme dryness of the eyes and mouth. His intellectual curiosity aroused, Sjo ¨ gren embarked on a PhD thesis, focusing on this disease. Over the next 3 years, he examined 19 cases, all women, aged 29 to 72 years. In 1933, he defended his thesis “Zur Kenntnis der Keratoconjunctivitis Sicca.” He detailed his corneal findings in these patients, specifically epithelial defects in the lower part of the cornea, as well as conjunctival ulcerations. His thesis, however, was
1214 found to be average, receiving the grade of 1.5 on a scale of 1 to 3. This did not allow him to be awarded the title “Docent,” a prerequisite to enter academia. He subsequently moved in 1936 to Jonkoping, Sweden, where he was superintendent of the first ophthalmology unit at the county hospital. It was there that he developed techniques of corneal transplantation. For his significant contributions to medicine, Sjo ¨ gren was awarded the Docent title from the University of Gothenburg in 1957 and was made a full professor in 1961. In 1976, at the age of 77, he was made an honorary member of the Swedish Rheumatology Society and presided over the first international symposium on Sjo ¨ gren’s syndrome, held in Stockholm. Sjo ¨ gren died in September 1986 from complications of a stroke.8,9
Rowe’s Maxillary Disimpaction Forceps The Rowe Maxillary Disimpaction forceps, used to mobilize the down fractured maxilla, is named after one of the giants in British oral and maxillofacial surgery, Normal Lester Rowe (1915-1991). Rowe was born in Gloucestershire, England, and educated at Malvern College, and received his dental degree from Guy’s Hospital Dental College, University of London in 1937. He then entered the British Army Dental Corps at the rank of captain and served during World War II. Rowe’s interest in maxillofacial trauma developed from his wartime experience, particularly his experience in the frontline casualty unit in Normandy immediately after D-Day. After the war, he received his oral surgery training in London and was appointed consultant in oral and maxillofacial surgery at Rooksdowne House, Basingstoke, Kent, where he came under the influence of the legendary Sir Harold Gillies. At Rooksdowne House he cultivated his interest in facial trauma as well as developing his skills in all aspects of oral surgery. At the same time he also completed medical school, again at Guy’s Hospital. As a dual-degree oral surgeon, Rowe became one of the first dental specialists to qualify for the Royal College of Surgeons. In the 1950s, British oral surgery was a fledgling field. Rowe took a leadership role in developing the specialty, establishing multiple maxillofacial clinics in numerous hospitals throughout England. Highlights of his long and illustrious career include completing the first maxillary osteotomy in the United Kingdom with Gillies in 1950, publishing the landmark text “Fractures of the Facial Skeleton” in 1955 with H.C. Killey, publishing the 2-volume “Maxillofacial Injuries” in 1985, and founding the British Association of Oral Surgeons. Public recognition of his profession achievements came in 1976, when he was awarded
PERSON BEHIND THE NAME
by Queen Elizabeth II the Commander of the Order of the British Empire.10-12
Le Fort Fractures Rene Le Fort (1869-1951) will forever be associated with the midfacial fractures he classified more than 100 years ago. He was born in Lille, France, to a medical family— his uncle was Leon Le Fort, a distinguished anatomist and surgeon of the era. At age 19, while in military school, he placed first in the medical school entrance examinations of the “Internat des Hopitaux de Lille” and was awarded his medical degree at age 21, being the youngest physician in France at that time. He subsequently trained as a military surgeon at the army hospital “Val-de-Grace” in Paris until 1899. In 1900 he conducted experiments on fresh cadavers, resulting in the publication of 3 papers in 1901 in “Revue de Chirurgie,” documenting his classification of the Le Fort fractures of the facial skeleton. Interestingly, a popular misconception is that Le Fort dropped human skulls off of buildings or dropped cannon balls on the skulls as part of his experiments. In reality, Le Fort’s methodology in his experiments was much simpler— he struck the cadaver heads with a club, a kick, or a vice, or struck the head against a table, in an organized and precise fashion, documenting how each facial bone reacted to blows of different degrees of force. In 1902, Le Fort returned to Lille to teach in the medical school. He remained there until 1912, when he rejoined the French army during the Balkan War to practice battlefield surgery. Two years later, at the outbreak of the Great War, Le Fort again became a frontline surgeon. He was cited for operating under dangerous conditions at the frontlines during the Battle of Dinant. At the end of the World War I, he returned to Lille as professor of operative medicine, children’s surgery, and orthopedics. He spent the remainder of his career in Lille. Le Fort passed away in 1951 at the age of 82.13,14
Dingman Mouth Gag The Dingman mouth gag is an essential part of cleft palate surgery, allowing for maximum access/visibility of the surgical field. It is named after Reed O. Dingman (1906-1985). Dingman was born in Rockwood, Michigan. He received his dental degree from the University of Michigan followed by a master’s degree/residency in oral surgery. Dingman was certified by the American Board of Oral and Maxillofacial Surgery in 1940 and subsequently became assistant professor of oral surgery at University of Michigan. During this time Dingman published a significant paper on the treatment of mandibular prognathism via
1215
SHAHID R. AZIZ
mandibular body osteotomy.15 He also completed medical school at the University of Michigan, followed by surgical and plastic surgical training at Michigan and Barnes Hospital in St Louis. The American Board of Plastic Surgery certified him in 1949. From 1948 to 1952, Dingman served as editor of the Journal of Oral Surgery. Ultimately, Dingman developed the section of plastic surgery at the University of Michigan, serving as chairman of the division until 1976. He also was intimately involved with the American Society of Maxillofacial Surgeons (ASMS). Dingman passed away at age 79 in December 1985.16 Although his origins were in dentistry and oral surgery, Dingman ultimately challenged the role of oral surgery. At the 1953 meeting of the American Society of Plastic Surgeons, Dingman presented a resolution to limit oral surgery’s scope of practice. Although initially rejected, Dingman again presented this resolution, now infamously known as the Dingman Resolution, to the ASMS. It was subsequently passed and the resolution was sent to the chief of surgery in every hospital in America, which in turn created difficulty for oral surgeons on a local level. Ultimately Dingman’s actions became a rallying point for American oral surgery, whose forthright action paved the way for the exceptional quality of training and privileges achieved by today’s oral and maxillofacial surgeon for the benefit of the public.17
Ludwig’s Angina Ludwig’s angina (bilateral submandibular and submental space infection) is perhaps one of only a handful of truly life-threatening emergencies faced by the oral and maxillofacial surgeon. It is named after Dr Wilhelm Frederick von Ludwig (1790-1865), the German physician who first described this deadly fascial space infection. Born outside of Stuttgart, Ludwig studied medicine at the University of Tubingen, receiving his medical degree in 1811. Napoleon’s attempted conquest of Russia forced Ludwig into the German Army (an ally of Napoleon at the time) as a medical officer. He commanded the Wurtetemberg field hospital in Smolensk. Ludwig was subsequently captured by the Russian Army and became the personal physician to a Russian countess in southern Russia. He was freed in 1814 when Germany’s King
Frederick I broke his allegiance with France and allied with Russia. Ludwig spent the next 50 years becoming one of Germany’s most repected physicians. In 1836 he presented a paper describing a fast-spreading infection involving the floor of the mouth and into the neck. Ludwig noted that this was almost invariably a fatal affliction secondary to airway obstruction. Ludwig died in 1865 at the age of 75. Ironically, his obituary noted that Ludwig succumbed to “an inflammation of the neck. . . . Which boded the worst. . .he lost his life suddenly with out any immediate warning.”18 Whether this was a Ludwig’s angina or not remains unclear.19
References 1. Aziz SR: The person behind the name. J Oral Maxillofac Surg 55:847, 1997 2. Welton TS: Biographical brevities: Stenson’s duct. Am J Surg 14:501, 1931 3. Wooden W, Erlen J, Futrell J: History of the salivary glands, in Granick M (ed): Management of Salivary Gland Lesions. Philadelphia, PA, Lippincott, 1991, pp xv-xix 4. Pearce J: Sir Charles Bell. J Neurol. Neurosurg Psychiatry 56: 913, 1993 5. Brian V: The man behind the name: Sir Charles Bell. Nursing Times 73:420, 1977 6. Obituary: Sidney Yankaur. Ann Otolaryngol 41:1268, 1932 7. Harry M. Seldin, oral surgeon dead at 79. N Y State Dent J 41:146, 1975 8. Wolheim F: Henrik Sjogren and Sjogren’s syndrome. Scand J Rheum 61:11, 1986 (suppl) 9. Mutlu S, Scully C: The person behind the eponym: Henrik Sjogren. J Oral Pathol Med 22:439, 1993 10. Levignac J: A tribute to the late Mr. Norman Rowe CBE. Br J Oral Maxillofac Surg 30:337, 1992 11. Blenkinsopp P: Obituary NL Rowe. BMJ 303:1056, 1992 12. Obituary: Norman Lester Rowe. Br Dent J 171:226, 1991 13. Tessier P: The classic reprint. Experimental study of fractures of the upper jaw. Rene LeFort MD. Plast Reconstr Surg 50:600, 1972 14. Patterson R: The Le Fort Fractures: Rene Le Fort and his work in anatomical pathology. Can J Surg 34:183, 1991 15. Dingman RO: Osteotomy for correction of mandibular malrelationship of developmental origin. J Oral Surg 2:239, 1944 16. Millard R: Reed O. Dingman MD. Plast Reconstr Surg 78:445, 1986 17. The Building of a Specialty: Oral and Maxillofacial Surgery in the United States 1918-1998. J Oral Maxillofac Surg 56:110, 1998 (suppl 3) 18. Burke J: Angina Ludovici: A translation, together with a biography of Wilhelm Frederick von Ludwig. Bull Hist Med 7:1115, 1939 19. Murphy S: The person behind the eponym: Wilhelm Frederick von Ludwig. J Oral Pathol Med 25:513, 1996