Immortal Women Essays In Medical Eponyms Ii


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Immortal Women Essays In Medical Eponyms Ii

  1. 1. The American Journal of Surgical Pathology 25(10): 1326–1333, 2001 © 2001 Lippincott Williams & Wilkins, Inc., Philadelphia Special Article Immortal Women: Essays in Medical Eponyms Part II Andrew G. Östör, M.D., F.R.C.P.A. “Every discovery, however important and apparently in the Kittitinny Range of northern New Jersey. My epoch-making, is but the natural and inevitable outcome guests find some of the entertainment strenuous, for they of a vast mass of work, involving many failures, by a shared in building the fireplace, the kitchen chimney and host of different observers.”—Starling in doing carpentry and other manual labor around the Part I of this series42 was devoted to women who place. It is also a good place for sketching, photography, inspired medical eponyms from mythology, literature, birds, flowers, cooking, eating and conversation.” She and art as well as patients themselves. The following herself was an expert carpenter, stone mason, and cabi- parts are devoted to real female scientists and physicians netmaker. Dorothy’s appearance at work was casual, her who first described a technique or disease, which now coiffure was dishevelled, and she very often had a ciga- bears their names. They are considered strictly in alpha- rette dangling from her mouth. During conversation she betical order. was usually too preoccupied to dispose of the ash which A rare congenital metabolic disorder,3 now called then became part of her costume. Each year the glycogen storage disease Type IV, was described by Christmas season officially began at Babies Hospital Dorothy Andersen (1901–1963) (Fig. 1), U.S. pediatri- with Dorothy’s glüg party, held in her laboratory. She cian and pathologist. She also described the triad of cys- concocted the drop herself: a hot, aromatic brew made tic fibrosis of the pancreas (mucoviscidosis), celiac dis- of burgundy, cognac, cinnamon, and cloves, and as ease, and vitamin A deficiency.2 Dr. Andersen was born Damrosch puts it “and Thor knows what else.” She died in Asheville, North Carolina. Her father migrated to the courageously of cancer of the lung.22,32 United States from the Danish island of Bornholm (itself In 1953 a method of assessing the physical status of an an eponymous locality) when he was 8 years old. Her infant at birth was developed. The Apgar score,5 devised mother was from Chicago but of old New England stock. by Virginia Apgar (1909–1974) (Fig. 2), is so widely Dorothy graduated from the Johns Hopkins Medical used that “every baby born in a modern hospital any- School and received her Doctorate of Medical Science where in the world is looked at first through the eyes of from Columbia University, where she became full Virginia Apgar.” 6 Apgar attended Mount Holyoke Professor of Pathology. She later held appointments at College and Columbia University and became Professor Babies and Presbyterian Hospitals, both as a pathologist of Anesthesia at New York Columbia-Presbyterian and pediatrician. Although best known for her work in Medical Center, the first woman to hold this position. endocrine pathology, she also contributed significantly to She was also an accomplished violinist and cellist.4 In delineation of congenital malformations of the heart. De- 1994 the U.S. Postal Service issued a commemorative spite her numerous friends, whom she entertained lav- stamp in her honor. At a March of Dimes Meeting ishly, Dorothy was a shy and perhaps even lonely person. shortly before her death she is quoted to have said that her Her great joy was her farm, about which she wrote: “My greatest regret was devising the score (apparently because chief hobby is my ‘farm,’ a primitive retreat well hidden of its abuse, Mendelawitz, personal communication, 2000). Ashby techniques are nonradioisotope methods for de- termining red cell volume and red cell life span by in- From the Departments of Pathology and Obstetrics and Gynaecol- ogy, University of Melbourne, Melbourne, Australia. jecting innocuous but different types of red blood cells in Address correspondence and reprint requests to Andrew G. Östör, the recipient and following the rates of disappearance of MD, 48 Anderson Road, Hawthorn East, 3123, Melbourne, Victoria, the respective cell types over time.7 This method is still Australia; e-mail: 1326
  2. 2. ESSAYS IN MEDICAL EPONYMS 1327 FIG. 1. Dorothy Andersen. Portrait by Frank Slater. (Re- produced with permission from the Journal of Pediatrics 1964;65:476–9.) FIG. 3. Winifred Ashby. (By permission of the Mayo described in current hematology texts. Winifred Ashby Foundation.) (1879–1975) (Fig. 3), pathologist, was born in London, England, and when 14 years old migrated with her par- A new syndrome of X-linked mental retardation was ents to the United States. She graduated BS from described by Joan Atkin and Katherine Flaitz8 and col- Chicago University in 1903 and MS from Washington leagues, known as the Atkin–Flaitz syndrome. Addi- University, St. Louis, in 1905, studied malnutrition in the tional features include short stature, macrocephaly, Philippines, and then returned to the United States where “coarse” facial appearance, but normal chromosomes. she taught school physics and chemistry. She began a Both women are geneticists who worked at the time in Fellowship at the Mayo Clinic where she became the Virginia and Iowa, respectively. first person to establish the correct red cell life span. She The Epstein–Barr virus (EBV) was named after made contributions to the diagnosis of syphilis and stud- Yvonne Barr (Balding) (Fig. 4) and Anthony Epstein, ied carbonic anhydrase in the brain. She was a gifted who discovered the virus in 1964. 25–27 Dr. Barr musician and composer. She left the Mayo Clinic in 1924 was born in Conlow, Republic of Ireland. She was head and worked at St. Elizabeth Hospital, Washington, DC, prefect at Banbridge Academy Secondary School and until her retirement.21,30 According to Dacie,21 “…she graduated, with honors, from Trinity College, Dublin, was ahead of her time; her papers remained on library majoring in zoology. After various research appoint- shelves largely unread and her technique was relatively ments she received her PhD from the University of unused until the late 1930s.” She is remembered now, London. Working in Epstein’s laboratory, the virus that but much of her career was spent in obscurity. ultimately bears their names was discovered (Bert Achong, from Trinidad, was the third collaborator). “The progress FIG. 2. Virginia Apgar. Courtesy of A.C. Long Health Sci- ences Library, Columbia University, New York, NY. FIG. 4. Yvonne Barr. Am J Surg Pathol, Vol. 25, No. 10, 2001
  3. 3. 1328 A. G. ÖSTÖR Melbourne ever since (in a suburb neighboring the au- thor’s). While raising two children she obtained a Diploma of Education and taught biology in secondary schools for 20 years. She is now retired and enjoys em- broidery, crafts, theatre, and traveling (personal commu- nication, 1999). Serendipity has also played a major part in the “finding” of Dr. Barr who preferred living incog- nito, away from the limelight (rather like the “finding” of Livingstone by Stanley, who was never really lost). Julia Bell, (1879–1979) (Fig. 5) (yes, she lived to be 100!), was a pioneer of human genetics and gave her name to the Martin–Bell syndrome (also known as the “fragile X” syndrome), X-linked mental retardation, macro-orchidism, and a characteristic but variable fa- cies.34 Dr. Bell was educated at Nottingham Girls’ High School and Girton College, Cambridge. At that time women were not eligible for a degree at Cambridge University, and she therefore graduated in mathematics at Trinity College, Dublin. Bell spent the next 6 years investigating solar parallax at Cambridge Observatory FIG. 5. Julia Bell. Courtesy of C.V. Mosby, St. Louis, MO. and then moved to University College, London, where she was employed as an assistant in statistics. In 1914, of science is littered with happy coincidences, chance prompted by her mentor Pearson, she commenced medi- observations and meetings that mark the beginning of cal studies at the London School of Medicine for Women successful lines of research. But few have involved as (Royal Free Hospital) and St. Mary’s Hospital, qualify- much serendipity in their early stages as the EBV,” wrote ing in 1920 and being elected to the fellowship of the John Galloway celebrating the 25th anniversary of its Royal College of Physicians in 1938. The major portion discovery.31 The search, which led ultimately to the dis- of Bell’s career was spent at the Galton Laboratory, covery of the virus, was set in train on March 22, 1961. University College, where she was a member of the per- On that day an unknown English “bush surgeon” from manent staff of the Medical Research Council. Her Trea- Uganda, Denis Burkitt, gave at the Middlesex Hospital in sury of Human Inheritance was the first systematic at- London the first account outside Africa of an unusual, tempt to document the distribution of human disease malignant childhood lymphoma, which now bears his within families. Bell received the Weldon medal from name.10 His first publication in 1958 had attracted no Oxford University for her contributions to biometric sci- attention at all. According to Epstein, “it was a fortunate ence. She was the author of many classic papers, includ- chance, therefore, which took me to the talk in which ing an article with J. B. S. Haldane on linkage of the Burkitt described how he came to realize in the course of genes for color blindness and hemophilia. This was the his surgical work that the many seemingly different lym- first demonstration “that the principles of linkage which phoid cancers of children in Africa were not disparate have been worked out for other animals also hold good entities, but all facets of a single, hitherto unrecognised for man.” Age did not impede her academic activities, tumour syndrome, commoner in endemic regions than all and she wrote an original article on rubella and preg- other children’s cancers added together.”28 The disease nancy at 80. Bell retired when she was 86, having out- appeared to have a characteristic geographic distribution lived three Galton professors: Pearson, Fisher, and related to climate, which suggested transmission by an Penrose. She had been a proponent of Women’s Suffrage insect vector. Epstein decided the cause must be an on- in her youth, although she was never involved in militant cogenic virus. Although viruses were known to cause activity. She remained unmarried but had the compan- tumors in animals for decades, there was no evidence ionship and affection of many relatives and friends. Bell kept in touch with genetics until her death.36,37,45 that they caused cancers in humans. Deep-frozen biopsy material was flown from Uganda to London, and after a The Call–Exner body, in the follicular cells of the long series of failures a successful procedure for cultur- ovary, is named after Emma Call (1847–1937) (Fig. 6) and Siegmund Exner.11 Call was one of the first women ing Burkitt’s lymphoma tumor cells was evolved and a new virus demonstrated by thin-section electron micros- physicians in the United States. She was born in copy (it could not be demonstrated by any other tech- Massachusetts and studied medicine at the University of nique). Dr. Barr left the team the year after the discovery Michigan, graduating in 1873. In response to a survey when she married an Australian and has lived in conducted by the University of Michigan Alumnae Am J Surg Pathol, Vol. 25, No. 10, 2001
  4. 4. ESSAYS IN MEDICAL EPONYMS 1329 to 1997. For 15 of those years she was the Director of the Radiology Residency Programme, where that library bears her name. It was during her residency at the Massachusetts General Hospital, Boston, that she recog- nized, with Dr. Cronkhite, a resident in Medicine, the syndrome that bears their names.1 She also met her fu- ture husband Jack Diner, who was studying medical il- lustration. Dr. Diner successfully balanced her medical career with motherhood, raising two sons and a daughter. Since her retirement she has kept busy with volunteer work, inter alia, teaching English and Hebrew. The Diners also established the Wilma and Jack Diner Student Art Acquisition Fund to support student artists. She finds it amusing that she was once introduced at a national radiology meeting as a pathologist (personal communication, 1999). Myrtelle Canavan (née Moore, 1879–1953) (Fig. 8) was born in St. John’s, Michigan, and became the first FIG. 6. Emma Call. Courtesy of Bentley Historical Library, University of Michigan, Ann Arbor. woman neuropathologist in New England. In 1898 she entered Michigan State College and the year after the University of Michigan. She obtained her M.D. in 1905 Council, she wrote of her college days in 1924: “I en- from the Women’s Medical College of Pennsylvania, tered the Medical Department of the University the first one of 36 women to graduate that year. Upon graduation year that women were admitted. The first class of women she married a fellow doctor. In 1907 she became a labo- 15 in number were naturally the objects of much attrac- ratory assistant at the Danvers State Hospital in tion critical or otherwise (especially critical) so that in Hawthorne, Massachusetts, where she subsequently be- many ways it was quite an ordeal.” [Courtesy of the came Head of Laboratories, and where she met Elmer Bentley Historical Library, University of Michigan.] As Ernest Southand, Professor of Neuropathology at part of her postgraduate studies she went to Vienna and Harvard Medical School and Director of the Boston studied the rabbit ovary with Siegmund Exner. She re- Psychiatric Hospital. This association was to foster her in- turned to America and practiced at the New England terest in neuropathology, which led to many meticulous Hospital for Women and Children from 1875 to 1917 as descriptions of brain and spinal cord pathology in a variety an attending physician and consultant obstetrician.38 She of diseases.29 Among her 79 articles was the syndrome of was the first woman to be admitted to the Massachusetts familial spongy degeneration in infants, to which her Medical Society in 1884. This was the culmination of what was called the “Ten year debate,” during which the chief opponent of women’s membership, a Dr. W. W. Wellington, held that women “were not fitted to practice by reason of their sex characteristics.”47 She was also active in church and philanthropic work for many years. Her work on the ovary was her sole contribution to the medical literature. Call–Exner bodies are also found in granulosa cell tumors of the ovary, where they are pa- thognomonic. When she died, she left no immediate relatives. A syndrome characterised by alopecia, nail dystrophy, pigmentation, diffuse intestinal polyposis, protein-losing enteropathy, osteomalacia, and malabsorption, 18 is named after L. Cronkhite and Wilma Canada (Diner) (Fig. 7). Wilma was born in West Virginia and raised in Kentucky, where she was told that little girls did not grow up to be doctors. She dispelled that myth by earn- ing her medical degree from Duke University in 1950 and becoming a radiologist, serving on the staff of the University of Arkansas for Medical Sciences from 1956 FIG. 7. Wilma Canada. Am J Surg Pathol, Vol. 25, No. 10, 2001
  5. 5. 1330 A. G. ÖSTÖR name was given.12 Although her paper might be criti- cized for identifying her case as Schilder disease, it must be remembered that each of Schilder’s four cases in his original report was different and surely represented dif- ferent disease processes (Raymond D. Adams, personal communication, 2000). Despite extensive studies of spongy degeneration of the nervous system, it was only recently that a biochemical basis for this disorder has been suggested.35 Another notable study reported on 1000 autopsy cases in institutionalized patients. In 1924 she became curator of the Warren Anatomical Museum at Harvard University Medical School, a position she held until her retirement. Dr. Canavan added hundreds of neuropathologic specimens to the museum and also ini- tiated various programs to effectively use the large ex- hibit area. She concurrently was appointed Associate Professor of Neuropathology at the Boston University School of Medicine. She was highly respected in the Boston community of neurologists. Canavan was FIG. 9. Erna Christensen. Portrait by Ingeborg Høyrup, innovative, saw health care trends, and advocated co- painted for her 60th birthday, which now hangs in the Neuropathology Laboratory of the Institute of Molecular educational medical education. She died in Boston of Pathology, University of Copenhagen, Copenhagen, Den- Parkinson disease. mark. Courtesy of Professor Folmer Elling. Progressive infantile cerebral poliodystrophy was de- scribed by Erna Christensen (1906–1967) (Fig. 9) and K. H. Krabbe.13 She was born on the “smiling and lovely daughter, her character was distinguished by the tradi- Danish island of Fyn.”44 She decided to become a doctor tional industriousness, solidity, and modesty of an old rural family. She graduated from medical school in 1931, at the age of 6 years when she was operated on for her doctoral thesis being on subdural hematoma, re- appendicitis at the Hospital Hyborg, and was taken care garded as a classic in Danish medical literature. It was of by an admired lady physician. It is ironic that her life her rotation in neurosurgery that proved to be the begin- ended in the same hospital from a malignant disease at ning of her life work as a neuropathologist and neuro- the comparatively early age of 61. Being a farmer’s surgeon. One of her mentors was Dorothy Russell in London. With her indefatigable application, her fine skill, and her intuitive understanding, she contributed to the many fields of neuropathology, attested to by her 99 publications on the subject. Being dually qualified, she was skilled in clinicopathologic correlation. She had firmly held views and demanded high standards from her coworkers, but she was most demanding on herself. At dinner parties in her beautiful home she was an amiable hostess. Her good temper and good humor were highly appreciated. During the summer of 1967 she suffered metastases from a previously excised carcinoma of the breast. Despite her knowledge of the nature of her ill- ness, she strove to complete her preparations for the VIth International Congress of Neuropathology, planned for Copenhagen, of which she was the President, and in this she persisted to within a few weeks before her death.44,46 In an obituary Van Bogaert writes: “None of us could have suspected at the time that this lady, so so affable, so vivacious and so full of good humor with a determination for the Congress to be a success was already suffering from a terminal illness”9 (author’s translation). The cryopathic hemolytic syndrome14 was described FIG. 8. Myrtelle Canavan. Courtesy of the Harvard Medi- by the American hematologists Mildred Clough (née cal Alumni. Am J Surg Pathol, Vol. 25, No. 10, 2001
  6. 6. ESSAYS IN MEDICAL EPONYMS 1331 Clark, 1888–1938) and Ina Richter. Clough was born in Newtonville, Massachusetts. After graduating from Wellesley College with honors she obtained her MD from the Johns Hopkins Medical School. As holder of the Mary Putnam Jacobi Fellowship, Dr. Clough pub- lished research, mostly in bacteriology, and later was appointed instructor in medicine. Subsequently, she con- tinued her work in the outpatient department and in pri- vate practice. Ill health, however, had forced her to cur- tail her work. She died of pneumonia and was interred in her native Massachusetts. She was married to Dr. Paul Clough, Associate Professor of Medicine at Hopkins, and had two children. (Courtesy of the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institution). The metabolism of glycogen (the Cori cycle)15 and glycogen storage diseases Types I and II16,17 were de- scribed by Gerty Cori (née Radnitz, 1896–1957) (Fig. 10) and her husband Carl. She was born in Prague, the FIG. 11. Marie Curie. eldest of three sisters, her father having been the director of a sugar company. She received her medical degree they moved to Washington University in St. Louis: Carl from the German University of Prague in 1920, the year as Chairman of the Department of Pharmacology and she married Carl, a fellow student. The association thus Gerty as a research associate (a usually dead-end posi- started was a lasting and happy one from the human tion typically allotted to wife-assistants throughout the point of view and, in terms of what it meant to science, one of the most fruitful and successful on record.41 The scientific establishment). This collaboration nevertheless elucidated the metabolism of glycogen and resulted in Coris emigrated to the United States in 1922 to work at the Nobel Prize in Medicine and Physiology in 1947 for the New York State Institute for the Study of Malignant the pair and Argentinian B. A. Houssay (being the third Diseases, thus helping to initiate a great movement of time this was awarded to a woman; see below). In the scientists from the Old World to the New, in search of same year she was abruptly promoted to Professor of that freedom of teaching and research without which our Biochemistry.43 Soon after she contracted myelofibrosis. civilization will not survive. During this period Gerty This, however, did not dampen her indomitable spirit, and Carl were advised to end their research collaboration and she went on to describe glycogen storage diseases, because it would be detrimental to his career. In 1931 which was the first proof that a defect in an enzyme was the cause of a human genetic disease.43 She died of renal failure, never giving up work until the very end. Accord- ing to Ochoa,40 “she was not only a scientist of enormous stature but a human being of great spiritual depth, en- dowed with the most precious gifts that can adorn human nature. She was modest, kind, generous and affectionate to a superlative degree and a lover of nature and art…” Much has been written about the French Curie family, two generations of which played a prominent role in the development of modern chemistry and physics. It com- prised Pierre and Marie Curie,33 their daughter Irène, and her husband (Jean) Frédéric Joliot, all recipients of the Nobel Prize. Suffice it to say Marie (1867–1934) (Fig. 11), born Mariya Sklodowska in Warsaw, Poland, is by far the most famous woman scientist and the only woman to have received the Nobel Prize twice, the first for physics in 1903 (with Pierre and Henry Becquerel) for their discovery of radioactivity by studying pitch- blend in 1898.20 She received the second in chemistry in FIG. 10. Gerty Cori. Courtesy of the Anderson Medical 1911, for her discovery of radium and polonium (the Library, Washington University, St. Louis, MO. Am J Surg Pathol, Vol. 25, No. 10, 2001
  7. 7. 1332 A. G. ÖSTÖR latter named after her native country). She also became identifying the Streptococcus bacillus as the cause, de- the first female professor at the Sorbonne. She was to- veloping a skin test, later known as the “Dick test” for susceptibility or immunity,23 and developing a vaccine. tally devastated after Pierre’s death (he died crossing a road in Paris on a rainy day, when he slipped and fell As a result they received the prestigious Cameron Prize under the wheels of a heavy horse-drawn wagon) when granted by the University of Edinburgh in 1933, given she was only 42. Nevertheless, she went on with her “to a person who, in the course of the five years imme- research while raising her two daughters in a generally diately preceding, has any highly important and valuable hostile male-dominated scientific clique. The epic biog- addition to practical therapeutics.” The discovery of the raphy (made into a TV series by the BBC in 1978), skin test unfortunately led to a long series of lawsuits written by Eve, her other daughter,19 has made public her over their attempts to receive patents for their methods of struggles for scientific recognition. Like many of the producing toxins and antitoxins (which some believe early workers in radioactivity, Curie had no idea of the cost them the Nobel Prize), even though they were to dangers of these penetrating rays to the body. She died of derive no personal gain. She was also active in child leukemia, almost certainly brought on by prolonged ex- welfare and founded the Cradle Society in Evanston, posure to the concentrated radioactivity of the ore she Illinois, one of the first medical professional organiza- tions to facilitate the adoption of children39 (also, cour- was purifying. The curie is a measure of radiation or emission. tesy of the Alan Mason Chesney Medical Archives of the In 1923 Gladys Dick (née Henry, 1881–1963) (Fig. Johns Hopkins Medical Institution). 12) was born in Pawnee City, Nebraska, daughter of a banker/landowner/grain dealer. After taking her BS from POSTSCRIPT the University of Nebraska (1900), she overcame her mother’s objections and attended Johns Hopkins Medical The author was delighted to hear from “Jane” of School. Turning to biomedical research, specifically to Ophelia syndrome (see Part I). She writes: “I find it blood chemistry, she went to the University of Chicago mildly amusing to be ‘immortal’ in the literature, but (1911) where she met her future husband, George under a pseudonym and a literary reference. I hope it Frederick Dick, who was working on the etiology of helps someone else’s family.” She goes on: “I hope you scarlet fever. In 1914 the newly married Dicks joined realise that you’re one of a very few people who has ever Chicago’s John R. McCormick Memorial Institute for got away with calling my Dad English. I suppose the Infectious Diseases where she remained until her retire- equivalent slander in your part of the world is to mistake ment in 1953. The Institute was founded with a grant a New Zealander for an Aussie!” (personal communica- from John D. Rockefeller, who made the gift for research tion, 2000: he is Scottish). Mea culpa. into scarlet fever after one of his grandsons died of the disease. Working together, they made major contribu- tions to the prevention and treatment of scarlet fever24 by Acknowledgments The author thanks Miranda Francis, and Michael Watson (the latter two having been inadvertently omitted from Part I) for library assistance, Josephine Morrison for checking the ref- erences, Virgil Fairbanks, MD, Robert Scully, MD, Thomas Wright, MD, Robert Young, MD, Bert di Paola and Lloyd Ellis for the photography. ADDENDA 1. Cowden syndrome, which did not make the deadline for Part I, is a rare autosomal dominant illness char- acterized by mucocutaneous stigmata, colorectal pol- yps, and an increased incidence of neoplasia in vari- ous sites. It was named after Rachel Cowden, the propositus. Lloyd KM, Dennis M. Cowden’s disease: a pos- sible new symptom complex with multiple system involvement. Ann Intern Med 1963;58:136–42. 2. In this age of acronyms the following “synthetic” ep- FIG. 12. Gladys Dick. Courtesy of the Alan Mason Ches- onym was brought to my attention by my son, Andrew ney Medical Archives of the Johns Hopkins Medical Insti- James Östör, M.D.: Sapho syndrome (synovitis, acne, tution, Baltimore, MD. Am J Surg Pathol, Vol. 25, No. 10, 2001
  8. 8. ESSAYS IN MEDICAL EPONYMS 1333 19. Curie E. Madame Curie (tr. Sheean V). London: William Heine- palmoplantar pustulosis, hyperostosis, and osteitis). mann, 1938. Sappho (c 610–580 BC), Lesbos, Asia Minor, a lyric 20. Curie P, Curie M. Sur une substance nouvelle radio-active, conte- poet, was celebrated throughout the ages for the beauty nue dans la pechblende. C R Acad Sci (Paris) 1898;127: 175–8,1215–7. of her writings. The word “lesbian” of course derives 21. Dacie JV. The life span of the red blood cell and circumstances of from the Greek island where she lived (apropos, there is its premature death. In: Wintrobe MM, ed. Blood, Pure and Elo- no evidence that she was a lesbian). quent. New York: McGraw-Hill, 1980:210–55. 22. Damrosch DS. Dorothy Hansine Andersen. J Pediatr 1964;65: 476–9. 23. Dick GF, Dick GH. A skin test for susceptibility to scarlet fever. REFERENCES JAMA 1924;82:265–6. 24. Dick GF, Dick GH. The etiology of scarlet fever. JAMA 1924;82: 1. 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