A History Lesson from Dr. Mark Haacke

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby CureOrBust » Sun Jan 10, 2010 4:10 am

SammyJo wrote:Is there a scientific standard we can consult, like how much past corroboration needs to pile up before the scientific community can reach a conclusion?
The irony here is that at this point, CCSVI would be seen as going against the "pile of corroboration", where MS is an autoimmune condition. However, even with the amount of corroboration that it has, luckily some doctors (Zamboni, Schelling, Putman, Dake, Haake, Simka etc etc etc) decided not to "accept" it. 8)

And yes, I think the article sotiris found is probably the more interesting (and correct dog one) one. Joan confused me with her changing dates.... :oops: 1935, 1936...

It doesnt contain any more information than sotiris has posted, but the reference is http://archneurpsyc.ama-assn.org/cgi/content/summary/33/5/929
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Postby dialed_in » Sun Jan 10, 2010 7:30 am

Thia sounds like it would be a good one to read through too, but I can't even get the first 150 words or an abstract.

THE BIOLOGICAL SIGNIFICANCE OF THE LESIONS OF MULTIPLE SCLEROSIS
Putnam
Science 28 September 1934: 295-296
DOI: 10.1126/science.80.2074.295


Just looking at the list of other articles that have cited it makes it look very interesting:

http://www.sciencemag.org/cgi/content/c ... 0/2074/295

Like this one, I'm sure it must have been brought up recently by someone:

VASCULAR PATTERN OF LESIONS OF MULTIPLE SCLEROSIS

ROBERT S. DOW, M.D., Ph.D.; GEORGE BERGLUND, B.S.


Arch Neurol Psychiatry. 1942;47(1):1-18.

The theory of a relation between the cerebrovascular system and the lesions of multiple sclerosis has been advanced by many workers. The first of many to assign a primary role to vascular lesions was Rindfleisch.1 Ribbert2 early maintained that the demyelinated areas were related to a primary disseminated thrombosis. He described a congested central vessel in all the sclerotic patches. In two small patches cut in serial section he found white blood cells in the lumen of the vessel, partly adherent to the vessel wall and partly filling the vessel as an embolus. He stated that these changes in the vessel were multiple thrombi and expressed the belief that they had an important causative role in multiple sclerosis. The most recent adherents to the idea that vascular lesions play a primary role in the pathogenesis of the lesions of multiple sclerosis have been Putnam and his collaborators.3 . . .
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Postby dialed_in » Sun Jan 10, 2010 7:59 am

This work by Putnam is really interesting. They were using ultrasound to produce brain lesions in cats, dogs and monkeys in different areas of the brain, then watching what happened.

http://www.ncbi.nlm.nih.gov/pmc/article ... 3-0205.pdf

ETA: If you're an animal lover, you probably don't want to read it.
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Postby sou » Sun Jan 10, 2010 8:37 am

ozarkcanoer wrote:My first response is if Putnam created an animal model that looked like MS then why wasn't there any follow up ?? The depression ? WWII ? Or just ignored like Gregor Mendel's genetics work.


I believe it must have been some kind of Semmelweis reflex. In addition, not any money could be made out of this "hypothesis" and soon after the war it was the beginning of the immune system's era, so ALL unknown diseases couldn't but be autoimmune.

Doctors give me the impression that they are very interested in doing "advanced things" to the body, as if they will be more respected if they do so. There is a motto in my field, software engineering:

"The fact that you CAN do it, does not necessarily mean that you SHOULD do it."

This must apply to all fields of science, not just computers.

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Shortest joke: "We may not be able to cure MS but we can manage its symptoms."
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Postby dialed_in » Sun Jan 10, 2010 8:59 am

This one would be another interesting one to read:

RESULTS OF TREATMENT OF MULTIPLE SCLEROSIS WITH DICOUMARIN
TRACY J. PUTNAM, M.D.; LUDWIG V. CHIAVACCI, M.D.; HANS HOFF, M.D.; HYMAN G. WEITZEN, M.D.


Arch Neurol Psychiatry. 1947;57(1):1-13.
ETIOLOGY OF MULTIPLE SCLEROSIS

EVIDENCE has been accumulating over recent years which indicates that vascular destruction, or, more specifically, probably a thrombosis of venules, is an essential link in the chain of causation of multiple sclerosis and the related "encephalomyelitides."1 This evidence may be summarized as follows:

1. Histologic pictures indistinguishable from the lesions of "encephalomyelitis" in the acute stage, and of multiple sclerosis when sufficient time has elapsed to permit gliosis to take place, have been produced experimentally in animals by the retrograde obstruction of cerebral venules2 and by the intravenous injection of various coagulants, especially organ extracts.3

2. Similar lesions are also often seen in pathologic material of human origin, following spontaneous thrombosis of veins of a certain size from any cause, or compression of a pial vein by a tumor.4

3. Thrombi, usually in venules and veins, have been observed in a large . . .


They were trying to see if treating it with an anti-coagulant would make any difference?

Dicoumarin
An oral anticoagulant that interferes with the metabolism of vitamin K. It is also used in biochemical experiments as an inhibitor of reductases.
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Postby Jugular » Sun Jan 10, 2010 9:20 am

After Putnam, MS research must have been victimized by a reverse Ockham's razor where convoluted complex theories were favored over simpler explanations with fewer assumptions.

Per Wikipedia:

Occam's razor (or Ockham's razor[1]), entia non sunt multiplicanda praeter necessitatem, is the principle that "entities must not be multiplied beyond necessity" and the conclusion thereof, that the simplest explanation or strategy tends to be the best one.


Since we seem to be engaging in a debate from 80 years ago, are there also articles where Putnam's model was directly or indirectly refuted?

Boy if CCSVI proves itself, medical science will need to overhaul how it goes about things. Also the proponents of the autoimmune Emperor must be feeling a tad chilled these days.
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Postby cheerleader » Sun Jan 10, 2010 9:22 am

More on Tracy Putnam and Thomas Rivers...two men who tried to define the causes of Multiple Sclerosis. The opposing teams in The Battle.
Both men were working to establish animal models for MS during the 1930s. As we know now, Putnam used dogs, linked to venous blockage-
http://www.oac.cdlib.org/data/13030/8s/ ... 39n78s.pdf

Tracy J. Putnam was born in Boston, Massachusetts, on April 14, 1894. Following A.B. (1916) and M.D. (1920) degrees from Harvard
University, his training included neurosurgery under Harvey Cushing at the Peter Bent Brigham Hospital (1925) and neurology with Stanley Cobb at the Boston City Hospital neurological unit (1929-33).Putnam wasdirector of the services of Neurology and Neurological Surgery at the New York Neurological Institute from 1939-47, and Professor of the same disciplines at the College of Physicians and Surgeons, Columbia University. During this period he was a founding member of the National Multiple Sclerosis Society (1946) and what later became the National Epilepsy Foundation (1946)


Thomas RIvers - used rabbits, then mice and found EAE-

The bacteriologist and virologist Thomas Milton Rivers spent over thirty years at the Rockefeller Institute as a researcher in the Department of Bacteriology and from 1937-1955, as Director. Working on measles and pneumonia, Rivers discovered the parainfluenzae bacillus and cultivated vaccine virus for human use, and during the 1950s, he played an important role in coordinating research on poliomyelitis as head of the National Institute for Infantile Paralysis. During the Second World War, Rivers led the Naval Medical Research Unit in the South Pacific, rising to the rank of Rear Admiral.
Between 1922 and 1955, Rivers molded Rockefeller into the preeminent laboratory for research on viruses, and in over 100 papers published during these years, Rivers addressed a range of topics relating to some of the most devastating viral diseases, including smallpox, Rift Valley Fever, and epidemic encephalitis. More importantly, he helped delineate the disciplinary boundaries of virology as both conceptually and methodologically distinct.

During the Second World War, Rivers again offered his services, serving as commander of the Naval Medical Research Unit in the South Pacific where his attentions were drawn to coordinating the effort to combat malaria and typhus. He eventually retired from the Navy with the rank of Rear Admiral. He returned to the Rockefeller in 1946, remaining for an additional ten years and eventually earning promotion to director of the institute (1953-1955).

link

Here is the interesting part, and the fact that screams out to me...Putnam helped establish the MS Society, Rivers was a virologist and EAE wasn't embraced at first.

The National MS Society...which PUTNAM HELPED FOUND- does not even mention the man's name in it's "History of MS" pamphlet. The guy started your group...where is he? Check it out at the NMMS website, search History of MS. Rivers is all over the brochure...

So, why was Putnam expunged? Something happened after WWII. Was it due to the Rockefeller Institute? Industrialized Military complex? I gotta get going, any other history buffs want to tell Putnam's story....go for it. Where are Putnam's dogs in the history books???

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Postby Jugular » Sun Jan 10, 2010 9:42 am

Perhaps this was the "TSN turning point" as we Canadian sports fans know it - the pivotal point at which the game changed.

This is from the MSIF:

Complexities—and an unrecognized breakthrough

In the decade after World War I, MS research grew more sophisticated. Abnormalities in spinal fluid were noted for the first time in 1919, though their significance was a puzzle. Myelin, which had been discovered in 1878 by Dr. Ranvier, was studied intensively under the microscope and the cell that makes myelin, the oligodendrocyte, was discovered in 1928.

The first electrical recording of nerve transmission, by Lord Edgar Douglas Adrian in 1925, established techniques needed to study the activity of nerves and launched a series of experiments to determine just how the nervous system works. Ultimately, six Nobel Prizes were awarded for these studies. The resulting knowledge included clarification of the role of myelin in nerve conduction and a realization that demyelinated nerves cannot sustain electrical impulses.

At this time, scientists suspected that some form of toxin or poison caused MS. Because most MS damage occurs around blood vessels, it seemed reasonable that a toxin circulating in the bloodstream leaked out into the brain, even though no researcher could find a trace of it.

Just before World War II, an important breakthrough occurred. An animal model of MS was developed out of research on vaccines. It had been known that people vaccinated against viral illnesses, especially rabies, sometimes developed a disease resembling MS. It had been assumed that this occurred because the virus in the vaccines was not completely inactivated.

In 1935, Dr. Thomas Rivers at the Rockefeller Institute in New York City demonstrated that nerve tissue, not viruses, produced the MS-like illness. By injecting myelin he knew to be virus-free into laboratory animals under the proper conditions, he could induce their immune systems to attack their own myelin, producing a disease very similar to MS.

This laboratory animal form of MS, called experimental allergic encephalomyelitis, or EAE, would later become an important model for studying the immunology and treatment of MS. In fact, it paved the way to modern theories of autoimmunity, for it demonstrated how the body can generate an immunologic attack against itself.

But most doctors in the 1930s were still analyzing toxins or checking blood circulation in MS. The importance of EAE to MS was virtually ignored.

Instead, a flurry of experiments in lab animals demonstrated that blocking the blood supply to the brain sometimes caused myelin to die. The damage looked a bit like MS. Doctors wondered if MS was caused by circulation problems, and they tried therapies to stimulate blood flow including blood thinners and drugs to dilate blood vessels. X-rays were also used to treat MS, although more for their novelty than for any sound scientific reason.

It would be many years before the essential similarity of EAE and MS was understood and a link between the immune system and MS was forged.

Reference

Written by Loren A. Rolak, MD. Reproduced by permission from the National Multiple Sclerosis Society, USA. © NMSS, 2003
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Postby dialed_in » Sun Jan 10, 2010 9:50 am

I've seen refferences of him trying different drugs as treatment of different diseases. So maybe he just switched from causation to treatment?

Here's another pdf of a study where they came up with another way to make more focussed lesions in the brain:

http://www.h4.dion.ne.jp/~kokoro_s/Pages/mohon.pdf

It's kind of madening that they were designing machines to do this instead of going back to his work on dogs and just closing off the jugulars like he did. Hindsight being 20/20, just think what they could have learned back then if they had closed them off, then opened them back up later?
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Postby cheerleader » Sun Jan 10, 2010 9:59 am

Instead, a flurry of experiments in lab animals demonstrated that blocking the blood supply to the brain sometimes caused myelin to die. The damage looked a bit like MS. Doctors wondered if MS was caused by circulation problems, and they tried therapies to stimulate blood flow including blood thinners and drugs to dilate blood vessels. X-rays were also used to treat MS, although more for their novelty than for any sound scientific reason.

It would be many years before the essential similarity of EAE and MS was understood and a link between the immune system and MS was forged.


from the paper you linked, dialed. Bob has mentioned on here before how the vascular paradigm was dismissed in the 50s, because doctors tried blood thinners and anticoagulants and it didn't stop MS from progressing. Isn't it interesting that a medicinal answer was sought, rather than looking for a mechanical cause of the circulatory problems....like what they did to the animals? Also, Putnam not only blocked blood in...he blocked it out, and created an MS disease in dogs. So close, yet so far. But I still want to know why Putnam, a founding father of the MS Society, is not even mentioned by them today?
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Postby cheerleader » Sun Jan 10, 2010 10:52 am

Here's one take on what happened to Putnam-
From Multiple Sclerosis through history and human life by Richard M. Swiderski page 159 (google books)

Senator Charles W. Tobey of New Hampshire sponsored the National Multiple Sclerosis Act, which began hearings before the Senate Subcommittee on Health of the Committee on Labor and Public Welfare on May 10, 1949. Senator Tobey's own daughter had multiple sclerosis, and he sought the advice of the National Multiple Sclerosis Society in composing the legislation. When the proposal for a National MS Research Institute was included in hearings on a National Health Plan in the House of Representatives in 1949, Ralph I Straus, the president of the NMMS, gave testimony, as did Senator Tobey, Mrs. Lou Gehrig and Dr. Tracy Putnam, as well as a number of other doctors, family members and patients.

They were not entirely in agreement. Most of the laypeople present sated that no progress whatsoever had ben made in the "fight" against MS and demanded the kind of government interventions that had made possible the mass production of penicillin, which in turn was credited tor the sustained health of Allied troops invading Nazi Europe. Putnam, who had been an active participant in MS research for the last two decades, was confronted by a discontented public who did not seem to know about the progress he and others had achieved since Cruveilhier and Carswell.

Putnam was the first major researcher to go public with a theory of MS cause and the prospect of a treatment in 1942, but in 1949 he could not claim great success for this treatment. Though he described further research into other medications, he was facing people who wanted results, no hypotheses.
He was also in private practice and had see the devastation of lives.....


because Putnam failed in treating MS with anticoagulants, the connection to the cerebrovascular system was tossed out. We hate failures in America, and it seems that the MS lobby wanted answers, not hypotheses. wow,
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Postby jay123 » Sun Jan 10, 2010 12:01 pm

Jugular wrote:........
It would be many years before the essential similarity of EAE and MS was understood and a link between the immune system and MS was forged.


Reference

Written by Loren A. Rolak, MD. Reproduced by permission from the National Multiple Sclerosis Society, USA. © NMSS, 2003


And now it looks like it has taken 70 years for this link to be discredited!
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Postby jay123 » Sun Jan 10, 2010 12:40 pm

I was just trying to find more information about Dr. Putnam. Here is a link about all his old medical records that are stored at UCLA -
http://www.oac.cdlib.org/data/13030/8s/ ... 39n78s.pdf


Also, it sounds like he must have been quite a maverick, which is also why maybe he didn't get the credit he deserved. Here is a link to an article about a time when people thought there were too many jewish doctors, but Dr. Putnam bucked the trend and got in trouble -
http://www.nytimes.com/2009/05/26/health/26quot.html
The mastermind behind this compromise was Dr. Putnam, a neurologist, neurosurgeon and psychiatrist who was named head of the Neurological Institute in 1939. A Boston Brahmin, Dr. Putnam was the vice chairman of the National Committee for Resettlement of Foreign Physicians. “It seems likely,” Dr. Rowland concludes, “that all of these European neurologists were appointed by Putnam.”

Dr. Putnam was forced to resign in 1947, ending his career at Columbia. Colleagues at the time suspected several reasons, including a lack of administrative skills, enemies on the staff and the conflicts that arose from having a neurosurgeon running a neurological institute.

But Dr. Rowland unearthed another explanation. A New York newspaper of the era, called PM, reported in 1947 that Dr. Putnam had been told to fire all of the “non-Aryan” neurologists, something he was unwilling to do.

Dr. Rowland corroborated this story when he discovered a 1961 letter written by Dr. Putnam to a fellow physician. Dr. Putnam reported that Charles Cooper, then head of Columbia’s affiliated hospital, Presbyterian, had told him in 1945 “that I should get rid of all the Jews in my department or resign.”

Although Dr. Putnam left, most of the Jewish neurologists stayed, under the leadership of Dr. Merritt. But Columbia did not have a Jewish physician as head of neurology until 1973, when Dr. Rowland was named to the position. He was only the third Jewish clinical chief at the institution.

Quotas for Jewish medical students and physicians disappeared fairly rapidly after World War II, partly in response to Nazi atrocities against the Jews. But Dr. Putnam’s quiet advocacy on behalf of Jewish physicians when such a stance was unpopular should not be forgotten.


And how about this from Time magazine, 1946. It sounds like the start of the NMSS -
http://www.time.com/time/magazine/artic ... 57,00.html
The patient first notices a pins-&-needles sensation in his legs. After a time his head and shoulders may twitch, his eyeballs roll wildly, he sees double, reels when walking, stumbles in his speech, from time to time is seized by uncontrollable laughing or crying jags. In advanced stages he may be paralyzed.

The patient is not drunk. These are symptoms of a mysterious, widespread disease known as multiple sclerosis, a disorder of the nervous system. Doctors have recognized it for nearly 100 years (the German poet Heinrich Heine is believed to have died of it), but they have never discovered its cause or cure.

Last week the first concerted attack on the disease was launched by a new organization started by multiple sclerosis sufferers. Based in Manhattan, the Association for Advancement of Research on Multiple Sclerosis has enlisted some of the top U.S. neurologists (honorary chairman: Dr. Tracy J. Putnam, director of Columbia University's Neurological Institute).

Neurologists estimate that multiple sclerosis is more prevalent than infantile paralysis. The disease is characterized by sclerosis (hardening) of scattered patches of nerves in the central nervous system. It has been attributed variously to 1) clots in the small blood vessels of the nervous system; 2) spasmic contractions of the blood vessels;(NOTE FROM ME - ISN'T THIS CCSVI?) 3) a spirochete (not the syphilis variety). But treatments based on these theories (e.g., anti-clotting and blood-vessel dilating drugs) do not cure the disease. It usually strikes between the ages of 20 and 35. It is seldom painful, and rarely fatal, but often cripples its victims.

Prime aims of AARMS: 1) raise funds for a full-dress research program; 2) determine the scope and prevalence of the disease.*

* A substantial number of sclerosis patients turn up in hospitals, but nobody has ever counted the much greater number who are treated at home by private doctors.

Read more: http://www.time.com/time/magazine/artic ... z0cF87aQQF


But one of the accomplishments he must be very proud of is portraying Dr. Timothy Brough in the classic 1963 movie "The Slim People". http://www.imdb.com/title/tt0056499/fullcredits#cast

I'd love to know more about this very interesting man. I've actually been searching the internet to see if he had a family, and perhaps even one of his kids became a doctor but not having any success. I think it would be great to get in touch with them and discuss whats going on now!

I also found reference to a foundation he started, but can't find any current info on it.
Last edited by jay123 on Sun Jan 10, 2010 5:03 pm, edited 2 times in total.
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CCSVI book

Postby alby » Sun Jan 10, 2010 1:00 pm

One of you guys should write a history book on CCSVI, and this is not a joke, I am serious. You guys know so much.
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Postby magoo » Sun Jan 10, 2010 4:25 pm

What a fascinating man Dr. Putnam was. Thank you for all of this important research. This will all mean so much when CCSVI has been proven finally!
Rhonda~
Treated by Dake 10/19/09, McGuckin 4/25/11 and 3/9/12- blockages in both IJVs, azy, L-iliac, L-renal veins. CCSVI changed my life and disease.
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