Karl Adolph von Basedow

Karl Adolph von Basedow (1799 – 1854)

Karl Adolph von Basedow (1799 – 1854) was a German general practitioner, surgeon and obstetrician.

Karl von Basedow had a reputation as an all-round, modern-thinking, and careful family doctor with broad and varied medical interests documented in 60 publications

1840 – described the ‘Merseburger Triad‘ of exophthalmos, tachycardia, goitre (later eponymously termed Basedow disease (AKA Graves disease, Parry disease)) and described many of the other main characteristics of immune hyperthyroidism.

Socially minded and practical, von Basedow fought to end the ‘unchristian breast-feeding by paid wet-nurses‘; to regularly test testing drinking water and to ban paints containing arsenic


Biography

  • Born 28 March 1799 Dessau, Germany
  • 1817-1821 Medical degree, University of Halle (Saale) [Thesis: Commentationes in novam amputationis cruris panniculatae encheiresin]
  • 1822 – GP practice in Merseburg
  • 1831 – Volunteered to help fight cholera epidemic in Magdeburg
  • 1841 – Royal Medical Counselor
  • 1848 – Kreisphysikus, state physician for the district of Merseburg
  • Died 11 April 1854 three days after performing an autopsy on a patient deceased by an unknown cause. Likely to have been a highly contagious infection, as the dressing woman and the hearse driver also died…

Key Medical Attributions:

Basedow disease

  • Von Basedow, in March 1840 described an association of exophthalmos, tachycardia, and goitre in four cases (Madamme F, G, C and Herr M) monitored over periods of 2, 5, 10 and 11 years. Described locally as the ‘Merseburger Triad‘ and in 1858 as Basedow disease [Hirsch 1858;2:224-225]
  • Von Basedow outlined the symptoms of hyperthroidism including intolerance to heat, profound sweating, diarrhea and weight loss in the presence of increased appetite.
  • Madame G and Madame F presented with symptoms of florid hyperthyroidism and exophthalmos and during the course of the disease, both were deemed to have become insane with Madame F admitted to a lunatic asylum.

There appeared an eminent protrusion of the eye balls, which by the way were absolutely healthy and had a completely full sight. In spite of this the sick woman was sleeping with open eyes and had a frightening appearance.’ Basedow;1840 (Madame G)

  • Herr M, was a 50-year-old man who in 1832 began feeling malaise and having diarrhoea. He suffered from ‘a heat of the blood‘, intense sweating, and oppression of the chest. He had a pale puffy countenance with protruding eyes (‘prominent like a crayfish’s eyes‘); the thyroid was enlarged; the patient was emaciated in spite of good appetite and continued to suffer from loose bowels.
  • Von Basedow described the connection between these symptoms and tried to explain the pathophysiological mechanisms. He proposed that the exophthalmos was due to an increase of the tissue behind the eye. He hypothesized that ‘dyscrasia of the blood‘ (i.e. mediated via the circulation) caused this tissue swelling and also the goitre. He described pretibial myxedema in two patients with thickened lower legs consisting of a ‘plastic brawn‘ not being impressible and not releasing fluid by puncture. Finally he described pregnancy as a most suitable cure! with symptom amelioration during, and exacerbation following pregnancy recorded in all of his three female patients.
  • In 1848, Basedow proposed the name Die Glotzaugen-cachexie [Goggle-eyed cachexia] for the constellation of symptoms he first described in 1840.

Schweinfurther Grün and the arsenic wallpaper:

  • Basedow presented proof of the poisonous effect of wallpapers printed with the paint colour ‘Schweinfurther Grün‘ (Parisian green) and Scheelesgrün initially in 1844, then in 1846 with ‘Arsenikdunst in Wohnzimmern‘ [Arsenic fumes in living rooms 1846;52(1):89].
  • He found that glue-bound Schweinfurter green releases organic arsenic compounds leading to arsenic vapours filling the confined spaces of living rooms. [1848;27:417-429]. Later deemed to be the production of trimethyl-arsine from fungus (Penicillium brevicaule) [1935;29:1757–1778]
  • Previously speculated that Napoleon Bonaparte (1769-1821) died of arsenic poisoning originating from the coloured wallpaper whilst on St Helena in 1821. An Italian research group analyzed hair samples of Napoleon at varying stages of his life and his contemporaries and found that arsenic was present in the environment in quantities that are considered harmful today. However, Napoleon exhibited similarly high levels of toxic metal in all stages of life and that his aggressive gastric carcinoma was a more probable cause of his death.

I died before my time, murdered by the English oligarchy and its hired assassin‘ – last will and testament Napoleon Boneparte 1821


Controversies

Country GP with multiple roles in the community. Even performed autopsy on his own daughter: ‘The little girl, unfortunately my own baby daughter died… At autopsy the heart was absolutely healthy and normal, however, in lungs, liver, spleen, and mesenterium there were multiple tubercles at the size of peas, some of them already being rather soft.‘ – Autopsy report from Dr. von Basedow


Medical Eponyms


Major Publications


References

  • Hirsch G. Cardiogmus Strumosus. In: Klinische Fragmente. 1858;2:224-225 [Hirsch: suggests Basedow disease]
  • Meng W. [Carl Adolph von Basedow–on the 200th anniversary of his birth]. Z Arztl Fortbild Qualitatssich. 1999 Apr;93 Suppl 1:5-10. [PMID 10355042]
  • Cadogan M. Eponymythology: Diffuse Toxic Goitre. LITFL 2018
  • Wenzel KW. Carl Adolph von Basedow (1799-1854). Milestones in European Thyroidology (MET)
  • Duntas LH. A tribute to Carl Adolph von Basedow: to commemorate 150 years since his death. Hormones (Athens). 2004 Jul-Sep;3(3):208-9. [PMID 16982595]
  • Hennemann G. Historical aspects, about the development of our knowledge of morbus Basedow. J Endocrinol Invest. 1991;14(7):617-624. [PMID 1940068]
  • https://archive.org/stream/wochenschriftfr06caspgoog#page/n654/mode/2up/
  • Emsley J. Napoleon: Aresenic in the hair. In: The Elements of Murder – A History of Poison. Oxford University Press. 2006:126-135
  • Fiorini E, Previtali E, Santagostino A. Kein Giftanschlag auf Napoléon. 12 Feb 2008 [No poison attack on Napoléon]
  • Seilnacht T. Schweinfurtergrün. SEILNACHT – Naturwissenschaften unterrichten
  • Challenger F, Higginbottom C. The production of trimethylarsine by Penicillium brevicaule (Scopulariopsis brevicaulis). Biochem J. 1935 Jul; 29(7): 1757–1778. [PMC1266683]
  • Stanbury JB et al. Iodine-induced hyperthyroidism: occurrence and epidemiology. Thyroid. 1998 Jan;8(1):83-100. [PMID 9492158]

eponymictionary CTA 2

eponym

the person behind the name

Posted by Dr Mike Cadogan

Emergency physician with a passion for medical informatics and medical education/textbooks. Asynchronous learning #FOAMed evangelist | @sandnsurf | + Mike Cadogan | LinkedIn

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