President’s Remarksby Matthew Lee, M.D.President 2010

I recently overheard a colleaguedisparage another colleague by

saying, “I practice evidence-basedmedicine, and he practicesanecdote-based medicine.” Theimplication is that the only crediblesource of information is peer reviewed,RCT, outcome driven data. That assess-ment may be a bit harsh, but this disagree-ment between my two friends made mereflect about this movement calledEvidence-based Medicine.

Like any movement, there must be abeginning. It seems largely agreed that theMcMaster University research group led byDavid Sackett and Gordon Guyatt were themidwives of the movement. David Eddyfirst used the term “evidence-based” in1990. The term“evidence-based medicine”first appeared in the medical literature in1992 in a paper by Guyatt et al. In theBritish Medical Journal in 1996, DavidSackett defined evidence-based medicineas “the conscientious, explicit and judi-cious use of current best evidence in mak-ing decisions about the care of individualpatients.” I think that most of us couldagree that this is a great way to approachpatient care. Some have complained, how-ever, about the “tyranny of evidence-basedmedicine” (Bonisteel, P. Can Fam PhysicianVol. 55, No. 10, October 2009, p.979). Bythis, they are referring to a “cookbook”approach, lamenting that it takes the indi-vidual patient out of the picture.

I wonder if the attraction to evidence-based medicine is not altogether differentthan the citizen that sees the answer to

society’s ills as, “Just follow the laws.” Yeswe do have laws and a Constitution toguide our behavior, but we also have judgesand juries. A law cannot account for everysituation, and interpretation is needed.Don’t get me wrong. I am not one whosays the truth is relative. I believe there is aTruth to be had; however, in my experi-ence, it doesn’t come easy.

With the patient in front of us, we areseeking the Truth. What is the best courseof treatment for this patient? The bestmedicine, the best imaging study, the besttherapy, the best lifestyle, the best . . . ? Weseek this as if there is a (singular) Truth.As I tell medical students, if we trulyunderstood the anatomy and physiology,understanding the treatment would beeasy. But therein lies the rub. Our under-standing is limited, at best. We are like thethree blind men walking around an ele-phant trying to comprehend what is rightin front of them. None can truly “see” theelephant, but by using their hands to touch

small parts of the beast, each can share hisexperience with the other two as theyslowly gain a better understanding. Noneof the three will ever understand the wholeanimal.

So which approach should we take? Relyon the best data from well-crafted studiesor use a country doctor approach relyingonly on experience? This is a false choice,of course. Evidence-based medicine is ahelpful tool in caring for our patients andis disregarded at their peril. However, anunbending adherence to statistical evi-dence can become tyrannical.

How then are we to approach the care ofthe patient? I find the definition given bySackett to be helpful. He said evidence-based medicine was a “conscientious,explicit and judicious use of current bestevidence in making decisions about thecare of individual patients”. I think thewords “conscientious” and “judicious”might hold the key. I would add just onemore word– humility. �

ILWAUKEE ACADEMYOFMEDICINE

Volume XXVII / May 2010

8 7 0 1 Wa t e r t ow n P l a n k Ro a d • M i lw a u k e e , W I 5 3 2 2 6 • 4 1 4 . 4 5 6 . 8 2 4 9 • f a x 4 1 4 . 4 5 6 . 6 5 3 7 • em a i l amy@m i lw a u k e e a c a d emyo fm e d i c i n e . o r g

Evidence-based anecdote: The Elephant in the Room

EVIDENCE-BASEDMEDICINE

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The 1,24thAnnual Meetingof the MilwaukeeAcademy of Medicine

January 19, 2010

by H. David Kerr, M.D.

The 124th Annual Meeting whichwas the 1,273rd meeting of the

Milwaukee Academy of Medicine washeld at the University Club on January19, 2010. Outgoing President SethFoldy presided. He opened the meet-ing by presenting the slate of officersfor 2010 which was elected unani-mously. A complete listing of the slateof officers can be found on the backpage of the newsletter. The electionwas followed by the presentation ofthe Humanitarian Award to John andJoel Rechlitz, two City of MilwaukeeFirefighters who risked their lives sav-

ing a mother and two children trappedin a burning overturned car. Theirfamilies and representatives of therenowned Milwaukee EMS systemaccompanied them to the presenta-tion. The award is given in recognitionof those who significantly improve thewelfare of our community by virtue oftheir courage, tirelessness, compassionand vision. Both expressed theirappreciation in modest fashion andwere given a standing ovation.

President-elect Matthew Leeassumed the chair and presented out-going president Seth Foldy with aplaque honoring his years of serviceand dedication to the profession ofmedicine. Dr. Lee’s inaugural remarksreminded the membership of theunique aspects of the Academy, itslong history, and its continued rele-vance to members and the communi-ty.

Dr. Lee then introduced the speakerof the evening, Milwaukee CountyExecutive Scott Walker. He presented

a detailed review of the health careresponsibilities inherent in the“Milwaukee County Budget 2010”. Indoing so he demonstrated consider-able knowledge of the various pointsin the organizational structure thatinvolve health care. The variegatedforms of health services scatteredthrough the unwieldy county budgetdefy simple reductions. Continuedbudget obligations threaten theCounty with insolvency. A number ofareas of the budget have been “pro-tected” from cuts and these includeEMS. Other budget areas are notmandated and could be discarded butfor their need by the community.There is much opposition to the fur-ther raising of taxes. Cutting salariesand laying off workers are opposed byunions and if done will mean a cut inselected services. The continuedupward spiral of health costs abettedby widespread gouging anticipatesinflation and probably propels it. Alively series of questions resulted. �

The 1,274th Meeting

February 16, 2010

by Nick Owen, M.D.

On February 16, 2010, theMilwaukee Academy of Medicine

assembled at the University Club forits 1,274th meeting. The business ofthe evening, conducted by PresidentMatt Lee included a request for nomi-nations for the Academy’sDistinguished Achievement Awardwhich recognizes contributions to theadvancement of knowledge and prac-tice of medicine by a Wisconsin physi-cian, the deadline for nominationsbeing April 1, 2010 and the presenta-tion of the award being at the Octobermeeting. Dr. Lee announced that nextmonth’s speaker will be Sam Hwang,

M.D., Ph.D., who will speak on thetopic “Why Do Melanoma CellsMetastasize”. The next business con-sisted of the reading of the names ofeight candidates for membership whowill be voted on at the March meetingincluding Janet Rader, M.D., (thisevening’s speaker). Others nominatedinclude:

Jeffrey Bahr, MDMarshall Beckman, MDJulian De Lia, MDThomas Heinrich, MDVinitha Kumar, MDPaul Lemen, MDBarbara Slawski, MD

Matt then introduced Dr. Rader,The Jack A. and Elaine D. KliegerProfessor and Chair, Department ofObstetrics and Gynecology, Medical

College of Wisconsin who spoke onthe topic “Towards a PersonalGenomics-Based Treatment forOvarian Cancer”.

After outlining the demographics ofovarian carcinoma and reviewing thenatural history and staging, Dr. Raderdelineated the modifications alreadyachieved by hormonal manipulation,surgery, and the evolution ofchemotherapy. She outlined the slowprogress we have had in combatingovarian cancer as opposed to othermalignancies as well as the complexi-ties of ovarian cancer itself.

Current work involves genetic eval-uation of tumor cells differentiatingthose variants whose biochemicalpathways can be interrupted by specif-ic chemotherapeutic regimens thusindividualizing therapy and improv-ing outcomes. �

Milwaukee Academy of Medicine Meetings

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The 1,275th Meeting

March 16, 2010

by H. David Kerr, M.D.

The 1,275th Meeting of theMilwaukee Academy of

Medicine was called to order at theUniversity Club on March 16, 2010by Dr. Daryl Melzer in PresidentMatthew Lee’s absence. Eight newmembers were voted on, accepted,and welcomed. (See list on page 2).

The evening’s speaker was Dr. SamT. Hwang, MD PhD, a member ofthe Academy and current Chairmanand Professor of the Department ofDermatology at the Medical College

of Wisconsin. He presented a veryinteresting talk on the topic of “WhyDo Melanoma Cells Metastasize?”Death from melanoma usuallyresults from metastases rather thanprimary site effects. He explored indetail the mechanisms of metastaticmelanoma which occur in severalsteps from bloodstream transport toproliferation. The propensity tometastasize depends upon the relativethickness of the primary melanoma.If the primary is thin and removedsurgically, metastases do not occur.Chemoattractant cytokines (orchemokines) and their receptorsare important in the progress ofmetastases. Much information aboutchemokine function was developedin studies involving leukocytes.Chemokines lead leukocytes to sites

of inflammation. Tumors are madeup of tumor cells, stromal cells suchas endothelial cells and fibroblasts,as well as inflammatory cells suchas neutrophils, lymphocytes, andmacrophages. Tumor associatedchemokines may inhibit rejectionand contribute to tumor growth byregulating inflammatory cells. Thesteps in the process of melanomametastasizing are being scrutinizedin exacting detail for points wherethe tumor is most vulnerable. Thetarget of anticancer therapy for thisproblem will likely be to suppressalready existing micrometastasesor to debulk life-threateningmetastases. Dr. Hwang’s fascinatingtalk was very well received andappreciated. �

The 1,276th Meeting

April 14, 2010

by Nick Owen, M.D.

The 1,276th meeting of theMilwaukee Academy of

Medicine was held at the UniversityClub on April 14, 2010 jointly withthe Wisconsin Beta Chapter of AOAwhich was inducting new members.The joint meeting produced robustattendance.

The meeting was opened afterdinner by President Matt Lee. Itemsof business included the announce-ment of the speaker for the Maymeeting, Dr. George Vaillant, aHarvard psychiatrist, whose topicwill be “The Evolution of theMammalian Limbic System and itsImplications for Society”.

Dr. John Basich was elected tomembership in the Academy.

Dr. Lee then introduced Dr. Jim

Sebastian who, after thanking thesponsors, the parents of inductees,and executive directors Amy John ofthe MilwaukeeAcademy of Medicine,and Leslie Mack of AOA, introducedstudent nominators of this year’sgroup of outstanding teachers select-ed from the faculty and house stafffor induction into AOA:

• Jean-François Liard, M.D.,Ph.D. – Professor ofPhysiology

• Bruce H. Campbell, M.D.,FACS – Professor ofOtolaryngology

• Jessica A. Crawford, M.D. –Department ofObstetrics/Gynecology

• Michael E. Curley, M.D. –Department of Medicine

• Kory D. Koerner, M.D. –Department of Medicine

Dr. Sebastian was joined by Dr. EdDuthie and Leslie Mack who pro-ceeded to introduce the 32 seniorstudent inductees to AOA, present-ing each with a certificate after relat-ing their home community, under-

graduate school and degrees, and cit-ing where they were interning and anamusing personal anecdote abouteach one. The AOA ceremony con-cluded with the reading of the namesof the 8 junior medical students whowill be inducted next year.

After honoring Leslie Mack forher role in upgrading the chapter,Dr. Sebastian introduced Dr. KarenBrasel who in turn introduced theevening’s speaker, Pauline W. Chen,M.D., Surgeon, New York TimesColumnist and Author of “FinalExam: A Surgeon’s Reflections onMortality” who entitled her presen-tation “Our Best Selves”.

Dr. Chen’s address centeredaround her coming of age as a surgi-cal house officer, her discomfort onher isolation and that of a relativeattending the ICU death of an elder-ly lady, and her rescue by a mentor(the attending surgeon) who taughther by example that respectful sym-pathetic interaction with family andthe terminal patient benefitted allinvolved, not least the physician. �

� 4 �

Santorio was born inCapodistria, a port city onthe mountainous Istrian

peninsula lying at the head of theAdriatic Sea, about sixty-fivemiles directly east of Venice and atthat time part of the Republic ofVenice. The mountains of theJulian Alps reach down to thesea here. First a city of ancientRome, Capodistria is a seasidehill town with a cathedral anddominating bell tower.Santorio’s father was a noble-man who had been appointedBombardier and ChiefSteward of Munitions of thecity, an important task as thearea was chronically beset byraiding pirates. His motherwas from a nobleCapodistrian family. Santoriohad a brother and two sisters.After completion of his stud-ies in Capodistria, he and hisbrother were taken by theirfather to Venice where hisclose friend, VincenzoMorosini, father of Paolo andAndrea Morosini, arrangedfor Santorio and his brotherto live and be privately edu-cated in the Morosini house-hold with his sons. TheMorosini family was promi-nent in Venice and had sup-plied three Doges to rule theRepublic. In addition theyhad ties to Istria. Tintoretto(1518-1594) had painted a por-trait of Vincenzo and another ofthe Morosini family with theRisen Christ. Santorio becameclose friends with the Morosinibrothers and received a superbeducation in philosophy, lan-guages, and mathematics (1).

At age fourteen he began hisstudies at the University of Padua.Under the protection of Venicesince 1440 Padua’s intellectualfreedom was instrumental inmaking it the most distinguishedcenter of learning in the latter part

of the 16th century and the 17th

century. Santorio began with thestudy of philosophy and finishedwith his degree in medicine sevenyears later.

For the next 14 years Santoriopracticed medicine in Venice andother areas. About five years after

graduation the King of Polandcontacted the faculty of Paduaseeking an excellent physician.Santorio was recommended as“most esteemed by us all” and isbelieved to have practiced inPoland, Hungary, and Croatia

during the next several years.He kept close contact by corre-spondence and paid frequentvisits to his friends and col-leagues in the Venice area.Santorio was in Venice in 1607when papal agents attemptedto murder his friend, PaoloSarpi, who was stabbed repeat-edly, beaten and left for dead.He underwent surgery done bySantorio and Fabricius ofAcquapendente, a prominentmember of the Padua medicalfaculty, and recovered.

Santorio was part ofVenetian intellectual society.On a regular basis meetingswere arranged at privatehomes that included those ofthe Greek scholar GiovanniLascaria and his old friendAndrea Morosini. Participantsincluded Paolo Sarpi, a priestwith a strong interest in sci-ence, Leonardo Donato andNicolo Conatrini both later tobecome Doges of Venice, PaoloParuta, a diplomat and histori-an, and Galileo Galilei.Minutes of these meetings

were not taken, but there wereopportunities for exchange ofideas with critiques and warningsgiven by friends. They discussedscience, politics, and undoubtedlythe church. Many of Santorio’sideas paralleled Galileo’s, and hisletters indicate his interest in thediscoveries of his friend. Notable

From the Academy’s Rare Book CollectionReview by H.D. Kerr, M.D.

Santorio Santorio (1561-1636)

Continued on page 5

Santorio Santorio (1561-1636)(also called Sanctorius Sanctorius)

Santorio, Santorio (1561-1636).Sanctorii Sanctoriide Statica Medicina,Aphorismorum…

Patavii B. Conzatti, 1710.Santorio, Santorio.

La Medecina Statica di SantorioDessantorj...

Venezia: Aresso D. Occhi, 1743.Santorio, Santorio.Medicina Statica:

Being the Aphorisms of Sanctorius,

Translated into Englishwith Large Explanations:

To which is added Dr. Keil’sMedicina Statica Britannica…

as also Medico-Physical Essays…By John Quincy. London:

printed for W.and J. Newton (etc.), 1720.Translation by John Quincy

with aphorisms added by him.Includes index.

� 5 �

visitors to Venice were invitedalso. Information was soughtfrom abroad regarding atti-tudes and innovations. By thismeans Galileo learned aboutthe development and uses oflenses in Holland. That newsled directly to his constructionof a telescope. Members some-times adjourned to the shop ofBernardo Secchini where “themost liberal and courageousmen would shape the destinyof the Republic and championits liberty and grandeur” (1).The best known of these wasGiordano Bruno, a controver-sial and outspoken priest inter-ested in Copernican cosmolo-gy. In 1600 he was accused ofheresy by the Roman curia andburned at the stake.

In 1602 Santorio wrote“Methodus vitandorum erro-rum omnium qui in arte med-ica contingent” (Method ofcombating all the errors whichoccur in the art of medicine), alearned and comprehensivetreatise on differential diagno-sis. It received a very favorablereception that led directly tohis professorial appointmentseveral years later. The bookwas filled with his owndescriptions of clinical experi-

ences as well as those describedby the ancients.

In 1611 Santorio wasappointed Professor of theTheory of Medicine at Paduafor 6 years (2). He was anexperienced and erudite physi-cian, a seasoned writer, andpossessed a creative drive thathad made him influential wellbeyond Padua. A change inthinking was in the air. Theolder ideas of using empirictreatment without an exami-nation were clashing withmovement in all of sciencetoward the gathering of factsand the use of experiment totest theories. Galileo had beenmightily impressed by thetranslations of ancient worksof Archimedes, his methods,and his knowledge of mathe-matics. Under his influenceSantorio was the first to makeuse of measurement and preci-sion instruments to makemedical observations. Herelied on reason and his owncommon sense. In the follow-ing year he wrote“Commentaria in artem medi-cinalem Galeni”. It included aclear description of how athermometer can be used inmedicine.

In 1614 he wrote “ArsSanctorii Sanctorii de staticamedicine”. It made him aworld figure with 28 Latin edi-tions, 2 Italian, plus English,French, and German editions.Here he described his carefullyplanned experiments inmetabolism. He sat himself onan apparatus consisting of a“steelyard balance” holding upa platform on which wereplaced a chair and table or abed. At the beginning the plat-form and all contents wereweighed including Santorio,the chair, the table, any papers,food, and clothing. At the con-clusion of the experiment theplatform and its contents wereweighed again and includedwere urine, stool, discardedmaterials, visible perspiration,and soaked clothing. The dif-ference in weight he reckonedwas due to “insensible perspi-ration”, the existence of whichhad been supposed by Galenbut never proven. He carriedout these weight determina-tions for decades night andday, and in all manner ofhuman activities includingexercise, rest, sleep, and inter-course. His conclusions werestartling. (3, 4)

Continued from page 4

Continued on page 8

Review by Nick Owen, M.D.

Therapy after Terror:9/11, Psychotherapists,and Mental Health

Seeley, Karen M., CambridgeUniversity Press, New York, 2008

Therapy after Terror is thestory of the multitude of

psychotherapists of variousprofessional disciplines (many ofthem un-reimbursed volunteers)who participated in the care of thevast number of psychologicalvictims of 9/11. It is also the story

of some of the good and bad out-comes of the care they delivered.One unusual outcome was psycho-logical trauma to a significantnumber of therapists through over-exposure to their patient’s repeatedrelation of the trauma they hadsustained .

Seeley discusses the evolution oftherapy: the most primitive beingthe World War I firing squadordered by courts martial for cow-ardice (an early military reading ofthe cause of “shell shock”).Attempts at searching for individ-ual underlying psychopathology orpsychoanalysis proved unreward-

ing as did dependence on theexhibition of psychotropic medica-tion. Ultimately talk therapyseemed most effective althoughthere did not seem to be agreementon the type of psychotherapy.

Absent a clear understandingof the pathophysiology andnatural history of stress inducedpsychopathology, there was afailure to establish a diagnosis orhierarchy of diagnoses which inturn might have facilitated a betterevaluation of therapeutic efficacy.

Nonetheless, we’ve come a longway from shell shock and firingsquads.�

Book Reviews

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Review by H. David Kerr, M.D.

An Infinity of Things:How Sir HenryWellcomeCollected theWorld

Frances Larson. Oxford UniversityPress, Oxford and New York, 2009

Henry Wellcome (1853-1936)and Silas Burroughs, both

Americans, founded the hugeBritish pharmaceutical firm namedafter them. Wellcome was born in alog cabin in Almond, Wisconsinand quit school at age 13 to go towork for his uncle, a physician whoalso sold pharmaceuticals. Hebegan his larger career as a travel-ling representative of a pharmaceu-ticals firm. From the start histalents were obvious, especiallyfor advertising and as a skilledexhibitor. His approaches tomarketing were fresh and energetic.Wellcome thrived in the give andtake of the business world and withBurroughs made a fortune in drug

innovations and marketing. Hehad collected a miscellany ofobjects since childhood.Arrowheads and stone tools foundnear his home in Minnesota weretranslated for him by his father asdisplaying the talents and the meth-ods of the long ago maker. Thus,knowledge could be represented bytangible things that interpretationcould clarify and transform intodetailed information. Not limitedby size or category he collected abirch bark canoe and a full sizedwigwam during his later NorthAmerican occupational travels.

After moving to Britain, marry-ing, and accumulating vast finan-cial resources he began to collectitems of medical interest, first aspart of marketing the company’sproducts and later to develop aHistorical Medical Museum. Heintended that the museum would“place before the medical profes-sion, in a collected form, all theinformation obtained.” He couldhave added “…from anywhere on

earth.” Continuing with his phar-maceutical business Wellcomeemployed buyers, curators, skilledworkmen, historians, caretakers,and numerous other specialists tocollect and assemble objects for hismuseum. This work continued forabout thirty-five years and ended athis death. The collection includedhundreds of ancient surgicalinstruments, medical texts extend-ing back hundreds of years, objectsused in the magic form of medicalpractice, paintings, illustrations,photographs, full size pharmacies,physicians’ offices, operatingrooms, and hospital wards . Manywarehouses were filled to bursting.The collection eventually saw thelight of day in fragmented form innumerous museums as near asLondon and as far as UCLA. As a“fanatical perfectionist” he under-took a huge task that he couldnever finish. The author tells thisstory in an interesting fashion lead-ing to a post modern obituary ofthe notion of museums. �

� 7 �

Review by Nick Owen, M.D.

The Great AmericanUniversity: Its Riseto Prominence, ItsIndispensible National Role,Why It Must be Protected

by Jonathan Cole, New York,2009, Public Affairs

Since Flexner, American physi-cians have acquired a bachelor’s

degree to qualify for medical schooladmission and received an M.D. ongraduation to qualify for medicalpractice. The majority of us arethus alumni of one or more of thegreat American universities ofCole’s title and at least nominallyinterested in their story.

Cole’s narrative is divided intothree segments: the rise topre-eminence, discoveries that alterour lives, challenges and lookingforward. He initially reviews thephilosophy of education, thehistory of educational institutions,and sketches the leaders thereof.

Cole then proceeds with a majorsurvey of the accomplishments ofeducational research institutionsand their integration with industryto produce the world as we know it.This is followed by a sectiondealing with political, financialimpediments to progress. He makesa final plea for renewal of academicfreedom.

Being retired and a history buff, Iread Great American Universitiesfrom cover to cover with pleasure.Since it is arranged chronologicallyand not divided topically ( byschool, discipline, or character), itis less suitable as a reference book.None the less, it provides anexcellent review of where we comefrom, how our alma maters evolved

to where they are, who discovered /developed what, and what all ofus need to do to continue progressand American leadership ineducation and research. �

CME TranscriptRequests

CME transcripts are availableto members upon request.

Please remember that they arenot mailed out automatically,you must contact the Medical

College of Wisconsin ContinuingEducation Department to makethe request for your transcript.

To receive a copy of your CMEtranscript for Academy programs,please contact the Medical Collegeof Wisconsin’s automated request

phone line at: 414/456-4896

You will be asked your name, mailingaddress and what years you would like

reflected on the transcript.

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8 7 0 1 Wa t e r t ow n P l a n k Ro a d • M i lw a u k e e , W I 5 3 2 2 6 • 4 1 4 . 4 5 6 . 8 2 4 9 • f a x 4 1 4 . 4 5 6 . 6 5 3 7 • em a i l amy@m i lw a u k e e a c a d emyo fm e d i c i n e . o r g

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�2010

Meeting Dates

May 18

September 21

October 19

November 16

All meetings are held at

the University Club,

924 East Wells Street,

from 6 to 9 p.m.

unless otherwise noted

on the program

announcement.

Contact the Milwaukee

Academy of Medicine office

for reservations:

amy@milwaukee

academyofmedicine.org

or 414/456-8249.

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�Email Reminder

If you have not already done so, please email your current email address to the Academy office,

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Although he was well regardedby students and fellow faculty, heresigned his position at Padua in1624. His lectures had beenextraordinarily well attended. Hedeclined offers from otherschools. In a gesture rarely made,the Venetian Senate in apprecia-tion of his work decreed that histitle would continue as would hisfull salary for the rest of his life.After leaving Padua, in 1625 hewrote “Commentaria in primamFen primi libri CanonisAvicenna” (Commentaries on thefirst part of the first book of theCanon of Avicenna). The bookwas not remarkable for com-ments on Avicenna but was for itsdescription of the first use of thethermometer in studying diseaseand the first description of aninstrument to count the pulse (apulsologium). The latter wasbased on adjustment of thesupport of a moving pendulum tomatch the pulse (5). Galileo waslikely the inventor of the ther-mometer, but three versions pro-duced by Santorio (one includinga bulb for oral use) were very dif-ferent and were clinically practi-cal. He also introduced an instru-ment for measuring humidity(hydroscope) and noted theimportance of humidity in dis-ease. Other new instrumentswere a tracheal cannula developedfor use in suffocation, a device tomeasure the force of wind, a bedfor invalids that included a toilet,a clyster with an insertion tube toextract bladder stones, and aninstrument to remove foreignbodies from the ear.

Santorio developed a largepractice in Venice, was electedpresident of the Venice College ofPhysicians, and was chief healthofficer in 1630 during a time ofplague in Venice when Conatriniwas Doge. Santorio died in 1636of a renal disorder. He was a veryinnovative thinker who associat-ed with others with whom heshared his ideas and listened totheirs. By all accounts he wasalso a remarkable physician whorejected empirical conclusions infavor of quantification andexperimentation to determinecause and thereby be truthful tothe patient. He never marriedand was devoted to his work. Hewas also a kindly father to thetwo children of his deceasedbrother Isadore. �

References:1. Castiglioni A. Life and work

of Sanctorius. Med Life1931;38:727-786.

2. Major RH. Santorio Santorio.Ann Med Hist 1938;X (5):369-381.

3. Loriaux DL. SantorioSantorio (1561-1636). TheEndocrinologist 2005;15(2);63-64.

4. Eknoyan G. SantorioSanctorius (1561-1636).Founding father of metabolicbalance studies. Am JNephrol 1999;19:226-233.

5. Levett J, Agarwal G. The firstman/machine interaction inmedicine:the pulsilogiumof Sanctorius. MedInstrumentation 1979;13:61-63.

continued from page 5

OFFICERS ANDMEMBERS OF THECOUNCIL FOR 2010

OFFICERS:Matthew Lee,

President

Daryl Melzer,

President Elect

Carol Pohl,

Treasurer and Finance

Kurt Pfeifer, Secretary

COUNCIL MEMBERS:Ellen Blank

Kavita Mundey

Seth Foldy, Immediate

Past President

COMMITTEE CHAIRS:BioethicsArthur Derse

Fund DevelopmentDonald Beaver

HistoryAlonzo Walker

MembershipEdwin Montgomery

NewsletterNicholas Owen and

H. David Kerr

ProgramHelmut Ammon

BOARD OF TRUSTEESElaine Drobny

Rita Hanson

James Hartwig

Erwin Huston

Ralph Schapira

George Walcott

Mary Wolverton

Walt Wojcik