Heinrich Quincke

Heinrich Irenaeus Quincke (1842 - 1922) 200

Heinrich Irenaeus Quincke (1842 – 1922) was a German physician.

He was a pioneer in the medical field and is remembered for numerous research contributions across a broad range of specialties.

Quincke introduced the technique of lumbar puncture for diagnostic and therapeutic purposes; and described angioneurotic edema, the capillary nail bed pulsation in aortic regurgitation, autopsy findings of hepatic artery aneurysm, causative organism of mouse favus, and the response to the stimulation of the carotid sinus.

Quincke’s name is eponymous with Quincke’s pulse (1868), Quiuncke’s oedema (1882), Quincke’s achorion (1886), and Quincke’s puncture (1891).


Biography

  • Born 26 August 1842, Frankfurt an der Oder, Germany
  • 1858-63 – Commenced (aged 16 years) and completed medical training at Friedrich-Wilhelm-Universität in Berlin, also studying in Würzburg and Heidelberg, under some of the leaders in medicine of his day, including Virchow, Langebeck, Müller, Helmholtz, and Bunsen
  • 1865 – Worked in hospitals across Europe, such as Vienna, Paris and London
  • 1866 – Appointed assistant in the surgical department of the Bethanien Hospital, Berlin
  • 1867-70 – Assistant physician at the Charité Hospital in Berlin under Professor Friedrich Theodor von Frerichs
  • 1870 – Professor and director of the department of internal medicine in Bern, Switzerland
  • 1878-1908 – Professor of medicine and head of internal medicine department at the University of Kiel ( Christian Albrechts University), Germany
  • 1900 – Appointed Rector magnificus of Kiel University
  • 1908 – Retired to Frankfurt am Main and pursued further research at the Senckenberg Institute
  • 1914 – Awarded honourary professor at Goethe University (Johann Wolfgang Goethe-Universität), Frankfurt am Main
  • Died 19 May 1922, Frankfurt am Main

Medical Eponyms

Quincke’s pulse (1868)

An alternate paling and flushing of the skin at the root of the nail while pressure is applied to the tip of the nail in aortic regurgitation.

Quincke published his observation of capillary and venous pulsations aged 26 years as an assistant in the Medical Clinic in Berlin. However, as Quincke pointed out, the sign of capillary pulsation is simply a normally observable phenomenon present in most people which just happens to be especially clear in patients with aortic insufficiency…so not really that useful

As far as the capillary pulse is concerned, so can one see it best on his own finger nail, or better, on that of another, in the area between the whitish, blood-poor area and the red injected part of the capillary system of the nail-bed; in the majority of persons examined, there is, with each heart-beat, a forward and backward movement of the margin between the red and white part…

A large and rapidly falling pulse is seen especially in aortic insufficiency, and for this reason the capillary pulse is especially clear in this condition.

Quincke 1868
Video of Quincke pulse/sign
Video Sources

Quincke’s oedema (1882)

Angioneurotic edema [Quincke’s disease] was previously described by others, including Robert James Graves (1796-1853) in 1843; and John Laws Milton (1820-1898) in 1876 who described the condition as ‘giant urticaria’.

I wish to identify a skin disease which does not seem to be rare; however, only a few cases of it have been described. This disease appears as oedematous swelling of the skin and the subcutaneous tissue in localized lesions from 2 to 10 cm. or more in diameter. These swellings are most common on the buttocks and on the face, particularly on the lips and eyelids. The swollen parts of the skin are not always demarcated from the surrounding tissue which may be pale or translucent or reddened. Patients usually have a sense of tension of the skin pruritus is not common—localized swellings also appear in the gastrointestinal mucosa producing symptoms…Because of its manner of development, acute localized swelling of the skin and mucous membranes, it should be considered as an angioneurosis

Quincke 1882

Achorion of Quincke (1886)

Causative organism of ‘mouse favus’ originally described by Quincke as α-Pilz. Now taxonomically defined as the dermatophyteTrichophyton quinckeanum.

Trichophyton quinckeanum taxonomic status
Trichophyton quinckeanum taxonomic status
  • Quincke H. Ueber Favuspilze. Archiv für experimentelle Pathologie und Pharmakologie. 1886; 22(1-2): 62–76

Quincke’s puncture (1891)

Lumbar puncture was developed by Quincke with his spinal puncture technique aimed specifically to withdraw cerebrospinal fluid in children with hydrocephalus. He had studied the formation of cerebrospinal fluid in dogs, and the communication between the arachnoid space in the brain and the spinal cord. He first presented the lumbar puncture and the diagnostic and therapeutic uses to the Congress on Internal Medicine in Wiesbaden in April 1891.

  • Quincke HI. Über hydrocephalus. Verhandlung des Congress Innere medizin (X). 1891; 321-39.

Quincke’s first case of lumbar puncture was on a 12 year-old boy who died despite six punctures of the ventricles in 1888. The second case in 1990 was of a boy 1 year 9 months of age with suspected tuberculosis meningitis that recovered after undergoing three lumbar punctures with three days between each. Case three described a 25 year-old man with severe headaches and chronic hydrocephalus that resolved with lumbar puncture. Quincke’s 1891 paper described lumbar puncture in five children and five adults.


Quincke spinal needle

This describes spinal needles with a Luer lock connection on the hub, and is designed with an A-bevel cutting sharp tip.


Key Medical Attributions

In addition to his important eponymous contributions, Quincke published on many other areas, including but not limited to: poikilocytosis in pernicious anemia, hemolysis of erythrocytes, hemosiderosis, caisson disease, iron salts and iron therapy, nutrition in diseases of the gastrointestinal tract, diabetic coma, surgical treatment of pulmonary abscess, the extrarenal cause of nephritic edema, amoebic dysentery and typhoid fever.


Controversies

Not…The Nobel Prize

Quincke was nominated for the 1909 Nobel Prize in Physiology or Medicine for his work on lumbar puncture, first presented in 1891. The nomination was rejected because the length of time, eighteen years, between the date of the discovery and the nomination. In 1918, a referee, who had earlier denied him the prize, now described his work on lumbar puncture as being of extraordinarily high diagnostic value and Quincke was unanimously recommended by the Nobel Committee for the Nobel Prize. However, at 76 years of age, he was considered too old for the honour (which later also affected Joseph Babinski).

Note: The Nobel rules were later changed and in 1966, Peyton Rous received the Nobel Prize in Physiology or Medicine for his work on tumour inducing viruses: at the age of 87; for a discovery that had been published 55 years earlier in 1911…


Major Publications


References


eponymictionary CTA

eponym

the person behind the name

Doctor in Australia. Keen interest in internal medicine, medical education, and medical history.

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