Kapronczay Károly szerk.: Orvostörténeti Közlemények 194-195. (Budapest, 2006)

TANULMÁNYOK — ARTICLES - ELEK, Gábor - MÜLLER, Miklós: Ervin Bauer as pathologist

latter diagnosis probably at the autopsy table. Since Addison's disease cannot unequivocally diagnosed on the basis of skin pigmentation (Kaufmann 1922, 1004), some of Bauer's diagnoses might have been erroneous. Bauer interpreted his observation by assuming that the toxic products arising in uremia overload the detoxifying capacity of the adrenal cortex, leading to its thickening and pigmentation. Detoxification is completely absent in Addison's disease and the toxic pigments accumulate in the skin. The Meirowski reaction was known at that time: unpigmented skin of Addison patients becomes pigmented when incubated in a thermostat (Baló 1962, 84). Bauer tested the skin of uremic patients as well, and observed that they also became pigmented. It is known now that in the skin of such patients urochrome accumulates, which also becomes colored upon oxidation (Cotran et al. 1989, pp. 10161017). Bauer's observation became well known and was mentioned in major textbooks for several years. In the fourth edition of Aschoff's monumental pathology textbook Gierke (1919) writes in his chapter on endocrine glands: ,, Recently Bauer assumed that the pigment found in the adrenal gland and skin is a product of oxidation of uric acid and a precursor of adrenaline" (1071). We find the same text in the fifth (1921, 997) and sixth editions (1923, 944). In the eighth edition the text is changed to: „// is hypothesized that in Addison's disease precursors not converted into adrenaline are converted into pigment by an enzymatic process." Bauer's name is no longer mentioned here (1936, p. 910). We find a similar sentences in Zfa/o's text „Adrenaliné is another source of mélanine... etc. " (1962, 82-83). Bauer made attempts to detect the pigment substance (metabolic product) with a histochemical silver impregnation, treating tissue sections or blocks with silver nitrate followed by reduction in a photographic developer (methol/hydrochinone). In its principle this procedure is close to the method to detect purines as described by Leschke that is indeed suitable for the demonstration of uric acid and purines but „ results obtained with these reactions need critical evaluation" (Romeis 1948, 501, 2139). Today this method is regarded an argirophilic reaction (Gabe 1976, 325) and it is no longer included into histochemical texts. The tissues bind the silver only weakly in the argirophilic reaction thus necessitating the use of an added reductant (Krutsay 1980, 60). In the argentaffinic reaction, in contrast, components of the tissue are reducing, giving a higher specificity. Bauer (1920a) explored this method further and demonstrated that the pigment detected with this reaction accompanies degenerative processes . (c) Tumors While various aspects of tumorigenesis remained a constant preoccupation of Bauer throughout his entire career, his contributions to tumor pathology consist of two papers only. The first published study of Bauer (1914), executed while he was a student in Göttingen, described an ovarial tumor, struma ovarii. In the beginning of the 20

th century the germ cell origin of monodermal teratomes was not universally accepted and struma ovarii as an independent entity was not even included in pathology texbooks until the 1930s. In the study of a case Bauer noted connections between the surface of the ovary and the epithelium of the ovarial struma. His teacher regarded this the most important finding: "The germinal (or surface) epithelium is regarded as the source of all epithelial neoplasms of the ovary...