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Wiki Page: Andrew Conway Ivy

Personal Life

In 1919, he was married to Emma Anna Kohman, who had her PhD in physiology from the University of Chicago. The couple raised 5 healthy boys. 4 of them became doctors and one started his own pharmaceutical company1.

Educational Career

Ivy was considered “one of the nation’s top physiologists” and “the conscience of U.S. Science” at the time of the Nuremberg trials in 1946, according to an article in Time magazine. At the Nuremberg trials, the German physician, Dr. Werner Leibbrant was interrogated on the stand and it became evident that the Germans questioning him were attempting to identify parallels between the medical research they did during the war and the human subjects research taking place in the states especially at Stateville, Illinois. This was unexpected for the United States front, and the biggest challenge for disputing these attempts was that there was no concrete guidelines and/or written documentation for the ethics of human medical experimentation. After Ivy initially appeared at the Nuremberg courtroom in January of 1947 and heard these proceedings, he went back to Illinois and asked the state Governor, Dwight H. Green, to set up a committee with him as the lead to assess the ethicality of the prisoner experiments that took place at Stateville. The governor agreed and sent out letters to potential candidates to join him on the committee. The committee search resulted in six members, and it was collectively called the “Green committee”. During the questioning of Ivy at the stand in June 1947 at the trials, the same attorney who had questioned Leibbrant to get to his point across regarding the equivalence of the U.S. human experimentation at Stateville, also probed Ivy, but with more focus on the Green committee, which had never actually met in person. After the trials, Ivy had returned to Illinois and wrote a letter to his fellow Green committee members to tell them the details of the testimony. For the next few months, the Green committee had met and worked on a final report to submit to the governor regarding their determination of ethics at Statesville. Their major conclusions were that the “all subjects [prisoners at Stateville] have been volunteers in the absence of coercion in any form.” The report was submitted to The Journal of the American Medical Association (JAMA). The report was published in February 1948 and it represented an important support for future prisoner experimentation in the United States. The conclusions drawn in the report, which praised the practices taking place in the research at Stateville, denounced all criticism of the work and would encourage it more2. Additionally, Ivy would generate new ethical guidelines for human research including the embryonic code of August 1946 which supported the use of animal experiments for protecting human life and the November 1947 statement which pleaded for physiologists and doctors to be against antivivisectionists in order to promote medical progress and human welfare. Altogether, the important points of his principles for human experimentation included 1) a need for consent, 2) carefully designing and planning experiments based on the results of animal experimentation in order to benefit society, and 3) performing these experiments by trained personnel to avoid mishaps and injuries that may result in a disability for the subject3.

Professional Focus

As a physician, Ivy did extensive research on cancer physiology and gastroenterology. He hypothesized that larger, multicellular organisms have an “anticancer substance” that helped to suppress the cancer which should have been more likely with more cells present. This substance he called “carcalon.” His work on the gastrointestinal system led to an important publication of his entitled “Peptic Ulcer.” This was co-authored with Drs. Morton Grossman and Bachrach. Ivy and his colleagues were able to publish more than 1500 papers. His work was so interesting that he was cited more than any other researcher between the years of 1964 to 1971. He is most known for this interest in gastroenterology in which he made breakthroughs in understanding pancreatic and gastric secretions, and the discovery of a hormone named cholecystokinin and urogastrone. In addition, his work resulted in new types of procedures including the “Ivy bleeding time” for diagnosing clotting abnormalities1.

Enterogastrone

One breakthrough in gastroenterology made by Ivy was the observance of hunger inhibition with fat. Ivy et al., was able to show that in their research presented at the Cold Spring Harbor Symposia on Quantitative Biology that neutral fat working in the upper intestine is able to exhibit inhibition of gastric secretion. This was evidence of a possible humoral mechanism, acting in the blood, which is causing the inhibition of hunger. The researchers were able to extract an inhibitory agent from the upper intestinal mucosa which was able to inhibit gastric secretions4.

1.           Ivy, C. Andrew c. ivy 1893 -. 11–14 (1939).

2.           Harkness, J. M. Nuremberg and the issue of wartime experiments on US prisoners. ''J. Am. Med. Assoc.'' 276, 1672–1675 (1996).

3.           Weindling, P. The Origins of Informed Consent: The International Scientific Commission on Medical War Crimes, and the Nuremberg Code. ''Bull. Hist. Med.'' 75, 37–71 (2001).

4.           Gray, J. S. Neutral ~ at inhibits gastric secretion and motility by acting chiefly in the upper intestine. (1935).

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Iatrochemistry in India

The use of plants, minerals and metals in medical therapeutics also existed in India. In Ayurvedic medicine, substances used in these therapeutics were known as 'Rasa dravyas.' Ayurvedic medicine instills the belief that every material had the potential to be used as a substance. This drove the creation of new products and new uses for common substances in nature. The people of Ayurvedic medicine categorize the materials in nature into three categories: 'Janagama,' substances from animals such as milk, urine, blood, and meat, 'Audbhida' or substances from plants such as stems, roots or leaves, and 'Paarthiwa' or metal/mineral substances such as gold, silver, copper or sulfur. There was especially an emphasis on the element, Mercury, in this culture. The name of these specific practices in Ayurvedic medicine, were termed 'Rasashaastra', which means the "Science of Mercury." which has eventually become known as Iatrochemistry in current terminology. Much of the focus of 'Rasashaastra' was on the processing of these metals to become ingestible by the human body. The therapeutic effect of the materials such as metals and minerals that were known to be indigestible by the human body were combined with plants or animal materials to increase their delivery ability to human body.

Hermann Boerhaave

Possibly being one of the most famous physicians of the 17th century, Hermann Boerhaave (1668-1738) approached phenomena in medicine with a scientific process of observation and experiments.He is most famous for recreating the Andrea Vesalius book of human anatomy. Booerhaave featured human beings participating in daily activities but with a transparency to them so that they're organs could be seen. His fascination with chemistry led him to model the human body in terms of its chemistry in the flows and interactions of the different phases including solids, liquids and gases. In his work, he narrowed down the causes of diseases to a substance called, "acid humour," which would affect flow of blood causing unbalance and detrimental chemical reactions, eventually causing malfunctioning of the human body. In a different example, it is documented that Boerhaave observed a certain "medullary oil" existed inside of bones which was very important for creating the "heat and vital motion" disturbances that could lead to an ill state of the body. A certain accumulation of a fluid in these joints of the body would lead to disastrous stagnancy which would be characterized eventually by gangrenous or unhealthy tissue where this occurred. This medical state was coined as "imposthumation."

Boerhaave is perhaps though, most well known in the realm of iatrochemistry for his discussions and understanding of the nervous system. Historians believe that Boerhaave's understanding of the human body and mechanisms in relation to the nervous and physical anatomy came from his personal interactions with soldiers in wars between the Dutch and Spanish. Through his understanding of the human body and chemistry, he was able to develop a medicine for physical injuries. Similar to the way that chemical reactions produce heat, Boerhaave attributed fevers to the body's response to a stressful situation or shock, in which an unexpected onset of heat or freezing temperatures was encountered.

Franciscus Sylvius

A German-born physician, Franciscus Sylvius (1614-1672) is best known in 18th century European medicine for his contributions to the understanding of the biochemistry of the body and the tubercles, and as one of the co-founders an iatrochemical school. In continuation of humoral medicine, Sylvius did deem diseases as resulting from excesses of the humors in the body, however it was a more chemically driven excess, specifically with too much acid or alkali solution in the body. Sylvius had his own laboratory in which he ran experiments on acids and alkali solutions to see the result when different mixtures were made. Much of his theories of the human body were based on the digestive processes. His understanding was that digestion helped food undergo a fermentation reaction. He rationalized the body functioned mainly as a result of chemical reactions, and of which acids and alkali were the essential reactants and products which needed to be kept in balance to be in a healthy state. Although Sylvius did not take on the more observation based style of medicine that was being so championed in the 17th and 18th centuries, his emphasis on the chemical reactions and knowledge helped support this more scientific medicine that was observation driven. It is known that many of Sylvius' inquiries did help in the future discoveries of certain enzymes driving food digestion and bodily reactions.

Diseases

The understanding of iatrochemists helped to drive new knowledge of how drugs work and treat medical conditions. Specifically, one English iatrochemist, Thomas Willis, considered the effect of diaphoretics (sweat-promoting drugs) as resulting from the mechanisms of the drug entering the blood and associating or disturbing blood and flow which produces a state of heat and sweat. He also hypothesized that the working of opiates came from an interaction with a salt in the body that created that painless and woozy feeling when reaching the brain. It was eventually realized that these explanations were not accurate.

Topic: Iatrochemistry/John Snow