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Medical Mycology in the United States A Historical
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MEDICAL MYCOLOGY, IN THE UNITED STATES, A HISTORICAL ANALYSIS. Ana Victoria Espinel Ingroff, Medical College of Virginia Campus of. Virginia Commonwealth University, Richmond VA, SPRINGER SCIENCE BUSINESS MEDIA B V. Library of Congress Cataloging in Publication Data is available. ISBN 978 90 481 6196 6 ISBN 978 94 017 0311 6 eBook. DOI 10 1007 978 94 017 0311 6, Printed an acid ree paper. All Rights Reserved, 2003 Springer Science Business Media Dordrecht.
Originally published by Kluwer Academic Publishers in 2003. Softcover reprint of the hardcover 1st edition 2003. No part of this publication may be reproduced Of, utilized in any form or by any means electronic mechanical. including photocopying recording or by any information storage and. retrieval systern without written permission rrom the copyright owner. Table of contents, Foreword vii, Acknowledgments Vlll. Preface ix, Introduction xi, Summary chart XV, CHAPTER I The origin of mycology. CHAPTER II The era of discovery 1894 to 1919 10, CHAPTER III The formative years 1920 to 1949 23. CHAPTER IV The advent of antifungal and immunosuppressive therapies 1950 to 1969 49. CHAPTER V The years of expansion 1970 to 1979 79, CHAPTER VI The era of transition 1980 to 1996 101.
CHAPTER VII Summary and conclusions 126, References 130. Appendix A Questionnaire analysis summary 143, Analysis 143. Tables 146, Appendix B Genealogic Training Trees 149. Appendix C Medical mycology books 203, Appendix D Historical publications by other authors 205. Appendix E List of questionnaire respondents and interviews 206. Author Index 210, Subject Index 218, In our contemporary world scientific heritage is cal Mycology infrastructure are recognized for their.
often forgotten Many important contributions dur scholarly and authoritative contributions This book. ing the past 100 years in research teaching and is truly a landmark publication towards ensuring. diagnosis have had a profound impact upon the that the past present and future are connected to. evolution of Medical Mycology in the United States each other. This book written by Dr Espinel Ingroff makes a, significant contribution towards ensuring that those Libero Aje lo Ph D. who have laid the foundation for our current Medi Michael R McGinnis Ph D. Acknowledgments, The invaluable editorial assistance and creative I owe a debt of appreciation to the following. reinforcement of my husband David Ingroff was individuals for their assistance during the gathering. especially important during the preparation of this of the data including the mailing of the question. book Special thanks go to Drs Libero Ajello naires Drs Michael Rinaldi and William Merz. Michael McGinnis and William Blake for their President and Treasurer respectively of the Medical. support guidance encouragement and continuous Mycological Society of the Americas in 1994 the. editorial assistance I would like to thank the numer Medical College of Virginia Tompkins McCaw s. ous medical mycologists who responded to the Library week end staff and the Library Interloan. questionnaire and or made themselves available for Service J Kerr Archivist of the American Society. interviews Also Drs Glenn Bulmer Timothy for Microbiology Drs W Dismukes and M Saag. Cleary Arthur DiSalvo Judith Domer Norman and Ms C Thomas of the NIAID Mycoses Study. Goodman Morris Gordon Carlyn Halde Richard Group Dr Dan Sheehan and T Webster of Pfizer. Hector Dexter Howard Leo Kaufman George Inc USA Pharmaceuticals and Mr Robert Scott. Kobayashi Kyung Joo Kwon Chung Geffrey from Merck US Human Health Sincere apprecia. Land Donald MacKenzie Thomas Mitchell John tion is due to Ms Joan Peters for her secretarial. Rippon Stanley Rosenthal Ira Salkin Wiley Schell assistance during the preparation of this manu. Margarita Silva Hutner Jim Sinski Paul Szaniszlo script. John P Utz and Mrs Norman Conant provided Finally special recognition is due Dr Arthur. invaluable archival documents personal papers DiSalvo whose persistent support was most valu. photographs and unpublished historical documents able in accomplishing the publication of this book. that gave greater depth to this study, The genesis of this work began with my desire to of debilitating and fatal fungal diseases In the area. determine how medical mycology has developed as a of research development the concern was that. science in the United States This idea evolved from medical mycology had not made the necessary. my search for a topic for my doctoral dissertation transitions at the same pace as the other branches. My original idea was to conduct historical research of microbiology in the 1970s when research moved. on the development of antifungal drugs which has from the whole organism to its molecular biology. been the primary focus of my career for the last and genetics Medical mycologists also became. twenty years However when I attempted to obtain uncertain regarding the sources of funding for train. access to archival documents from pharmaceutical ing and research because of the significant decreases. companies involved in the development of such in these funds that began in the early 1980s With. drugs both in Europe and the United States their these issues in mind I conducted a historical inquiry. uniform response was that such archives were closed into the development of the discipline which pro. to individuals outside the company At this point vided insights into why and how its development and. although it appeared to be a formidable task I progress had been affected during the last I 00 years. decided to broaden my research and investigate the What is the field of medical mycology This. development of the discipline in this country Next I discipline is concerned with the study of medically. determined the extent that this investigation was important fungi and fungal diseases in humans and. needed and who would utilize the results During other animals With this description of medical. the 1993 Focus on Fungal Infections meeting in mycology in mind this book may serve as a refer. Tucson Arizona and the Conference on Candida ence tool or a source of learning about the discipline. and Candidiasis in Baltimore Maryland I con for individuals who are interested or involved in the. ducted informal interviews with medical mycology different aspects of medical mycology patient man. leaders who were involved in patient care research agement clinical basic and applied research. and the training of future medical mycologists I also laboratory diagnosis as well as education and train. interviewed retired leaders by phone My initial ing It will also be a reference book for medical. findings were that most of these medical mycologists microbiology and medical technology students It. had a number of concerns regarding the current provides overall and detailed chronological descrip. state and future development of the science in this tions of the most significant scientific educational. country and technological medical mycologic events that. Since the beginning of the 1990s the perception took place from 1894 to 1996 in the United States. was that the discipline was changing rapidly and that What other publications could supplement the. training and research programs in medical mycol information provided in this book A search of the. ogy were decreasing in number and scope in the literature revealed that there are no comprehensive. United States On the other hand a significant historical studies of the development of medical. increase in the incidence and prevalence of nosoco mycology in the United States Uncovered were a. mial yeast and mould infections has been evident As few monographs and a number of obituaries regard. a result of improved management protocols AIDS ing pioneer American medical mycologists and. and other immunosuppressed patients live longer works concerning certain epochs and topics in this. but remain highly susceptible to life threatening country and Europe Some of these publications are. opportunistic fungal infections Since it is not man chronologies that are considered summary general. datory that physicians and other health care profes izations by historians In addition my interviews. sionals report mycotic diseases it is difficult to indicated that efforts were made in the 1980s to. compare their incidence and prevalence with that of publish a biographical book regarding medical. other infectious diseases Leaders in the field felt that mycology s pioneers up to 1960 However it appears. additional trained personnel were essential to that financial difficulties precluded publication of. respond to the increased incidence and prevalence that work Important information was obtained. from several of these unpublished chapters and other training in medical mycology worldwide These. historical publications cited in the list of references works however do not provide an in depth con. In 1986 Ainsworth published his Introduction to The sideration of any particular country or area Appen. History ofMedical Mycology and Drouhet published dix D briefly summarizes these and other related. in 1992 a handbook on mycology that included an publications. introductory chapter on the history of education and. Introduction, Fungal infections occur throughout the world but steadily during the decade of 1980 to 1990 expendi. some of them are more predominant in certain tures for training and research contracts decreased. geographic areas Although fungal diseases usually Direct NIH investments in training rose slightly but. are not considered to be as common as bacterial and fell dramatically when discounted for inflation. viral diseases they are frequently associated with Expenditures for research related to AIDS. severe morbidity and mortality Among the super accounted for approximately 20 of the overall. ficial fungal infections tinea pedis athlete s foot extramural programs while other training and. and pityriasis versicolor are among the world s most research contracts declined As governmental. common diseases sources of funding are reduced the academic and. The increased frequency and severity of mycotic medical communities seek more support for educa. diseases have prompted greater research efforts in tional and research activities from industry These. the development of antifungal drugs However developments have led to closer collaborations. despite those efforts in 1996 there were only six between academic and corporate researchers Due. antifungal drugs licensed in the United States for to varying economic conditions in the future corpo. use against systemic fungal infections Furthermore rate funding can be expected to become even more. the newer candidate drugs required further evalua restricted and difficult to obtain. tion of their efficacy because their spectrum of effect What has been the trend for funding of medical. and application in the eradication of the various mycological training and research In the beginning. mycoses remained unanswered The need for more of this century philanthropic and private organiza. effective economical less toxic and easier to admin tions e g the Harvard Traveling Fellowship the. ister antifungal agents to treat systemic fungal infec College of Physicians the Rockefeller Foundation. tion was clearly evident The evaluation of new and the Brown Hazen Foundation provided grant. compounds and management approaches support for training and research in medical mycol. demanded more training and research programs ogy However those contributions were usually small. It never has been easy to acquire formal training and generally had ceased to exist by 1996 At that. in medical mycology The training of a medical time some fellowships and grants for medical mycol. mycologist has been considered a twentieth century ogy were being supported by Pfizer Inc US Pharma. innovation As the incidence of fungal diseases ceuticals Group and Janssen Pharmaceutica. increases there is clearly a need for more and better The purpose of this study was to investigate in a. trained individuals Two concerns require immedi historical context the development of medical. ate attention the replacement of the diminishing mycology training and research in the United States. number of senior mycologists and the provision for The development of this discipline has been assessed. broader based multidisciplinary training programs within the context of scientific progress as demon. to better meet the new challenges ofthe 21st century strated by the creativity and scholarly contributions. More training programs should be established at from training research and technological activities. both the pre and postdoctoral levels with molecular directed toward the control of fungal diseases The. biology as a major component These endeavors study covers the historically significant as well as. demand the provision of more financial support decisive educational scientific and technological. and allocation of other key resources to medical events that have guided the development of medical. mycology in this country mycology in this country since the late 1800s It. The largest portion of federal funding for health includes key figures who led the field and the effect. oriented research is administered through the of their ideas and visions on the evolution of the. National Institutes of Health NIH Kennedy s discipline However the scope of this book does not. MEDICAL MYCOLOGY IN THE UNITED STATES A HISTORICAL ANALYSIS 1894 1996 by Ana Victoria Espinel Ingroff Medical College of Virginia Campus of

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