Ivar Wickman
Encyclopedia
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
physician, who discovered in 1907 the epidemic and contagious character of poliomyelitis
Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...
Education and academic career
Son of a merchant, Wickman began his medical studies at Lund UniversityLund University
Lund University , located in the city of Lund in the province of Scania, Sweden, is one of northern Europe's most prestigious universities and one of Scandinavia's largest institutions for education and research, frequently ranked among the world's top 100 universities...
in 1890, and passed the state medical examination in 1901 at the Karolinska Institute
Karolinska Institutet
Karolinska institutet is a medical university in Solna within the Stockholm urban area, Sweden, and one of Europe's largest medical universities...
at Solna
Solna Municipality
Solna Municipality is a municipality in Stockholm County in east central Sweden, located just north of the capital Stockholm. Its seat is located in the 'city' of Solna....
near Stockholm
Stockholm
Stockholm is the capital and the largest city of Sweden and constitutes the most populated urban area in Scandinavia. Stockholm is the most populous city in Sweden, with a population of 851,155 in the municipality , 1.37 million in the urban area , and around 2.1 million in the metropolitan area...
. In 1905 he published his doctoral thesis on poliomyelitis “Poliomyelitis acuta” in German, and the doctoral exam in 1906 qualified for the post of a docent for neurology at the Karolinska Institute, besides working as a district physician in the Östermalm district in Stockholm from 1907 to 1909.
As a pupil of pediatrician Karl Oskar Medin
Karl Oskar Medin
Karl Oskar Medin was a Swedish pediatrician. He was born at Axberg, Örebro and died in Stockholm. He is most famous for his study of poliomyelitis, an illness often known as the Heine-Medin disease, named after Medin and another physician, Jakob Heine...
, whom he held in high esteem, Wickman predominantly devoted himself to the studies of infantile paralysis (poliomyelitis). Besides his thesis, his 1907 publication Beiträge zur Kenntnis der Heine-Medin’schen Krankheit has been rated as innovative. In the field of neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
he also published several articles.
After 1909 Wickman spent more and more time abroad. He worked at the institute of pathology and anatomy in Helsingfors
Helsinki
Helsinki is the capital and largest city in Finland. It is in the region of Uusimaa, located in southern Finland, on the shore of the Gulf of Finland, an arm of the Baltic Sea. The population of the city of Helsinki is , making it by far the most populous municipality in Finland. Helsinki is...
and did psychiatric studies in Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...
. Repeatedly having to cope with financial difficulties, he spent his last two years in Breslau and Straßburg
Strasburg
-Places:*Strasbourg, a city in Alsace *Straßburg, Austria, in Carinthia*Strasburg, Germany, Mecklenburg-Western Pomerania*the former name of Brodnica, became Polish after World War I*Strassburg, the German name for Aiud, Alba...
, in both places working as an assistant to Adalbert Czerny
Adalbert Czerny
Adalbert Czerny Adalbert Czerny Adalbert Czerny (25 March 1863 – 3 October 1941 was a German pediatrician and is considered co-founder of modern pediatrics. Several children's diseases were named after him.-Education and career:...
, the co-founder of modern pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
. At the age of 41 he took his life by a shot in the heart in April 1914.
Application for the Medin chair
The reasons for his suicide are not known, since Wickman did not leave a farewell letter or any other notes. Colleagues report that the failure of his application for the post of Professor of PediatricsPediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
at the Karolinska Institute, which, until 1914, Medin had held, was a heavy blow for him. .
When the position was opened for applicants in 1912, Wickman was convinced that he had great chances of becoming successor to his mentor. The commission of the Stockholm Faculty of Medicine, however, preferred one of his two co-applicants in December 1913. On the one hand the members of the commission blamed Wickman for not having shown sufficient diversity in his research work: as many as half of his 22 scientific publications were dealing with polio. On the other hand there was the serious reproach that he had not given a public audit lecture, which was part of the application procedure. He had reported sick because of his "insomnia“ and only submitted a sick note by Professor Czerny, who acknowledged his pupil’s good didactic capacities. There is much reason to assume that Wickman eschewed the public lecture because of his stuttering
Stuttering
Stuttering , also known as stammering , is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases, and involuntary silent pauses or blocks in which the stutterer is unable to produce sounds...
, which considerably hampered his fluency of speech.
Work in polio research
Jakob Heine
Jakob Heine was a German orthopaedist. He is most famous for his 1840 study into poliomyelitis, which was the first medical report on the disease, and the first time the illness was recognised as a clinical entity...
and Adolf von Strümpell
Adolph Strümpell
Ernst Adolf Gustav Gottfried von Strümpell was a German neurologist who was born at Neu-Autz Estate, Courland Governorate...
he made detailed clinical and epidemiological studies to establish the hitherto controversial hypothesis that polio can be transferred through physical contact.
He was provided with illustrative evidence mainly from the great Swedish epidemic of 1905 with a total of 1,031 recorded cases. Using the example of the small village Trästena in today’s Töreboda
Töreboda Municipality
Töreboda Municipality is a municipality in Västra Götaland County in western Sweden. Its seat is located in the town of Töreboda....
he could show that persons with a large contact surface were infected with polio more easily. Within only six weeks 49 children had contracted the disease. First he observed a spreading of the disease along streets and railway lines. After weeks of field trials Wickman succeeded in establishing the fact that the local school played a prominent role in the spread of the disease which henceforth he named Heine-Medin disease.
Wickman published most of his articles and books in German and most of them were quickly translated into English. He came to the result that polio was highly contagious. He suggested taking the so-called abortive and nonparalytic cases as seriously as the grave ones with paralysis, since they were – as he emphasized – instrumental in the spread of the disease. He assumed that the agent
Pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...
could be passed on by presumably healthy persons, and he was the first to find that polio was not exclusively, not even mainly, a disease affecting the central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...
. Based on his observations he came to the result that the incubation period
Incubation period
Incubation period is the time elapsed between exposure to a pathogenic organism, a chemical or radiation, and when symptoms and signs are first apparent...
of polio was three to four days, which had long been disputed but was confirmed in the middle of the twentieth century.
When he coined the term Heine-Medin disease he followed a suggestion of Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...
, who considered the naming of a disease after its discoverer less problematic than naming it after symptoms or agents. Wickman had found out that Heine’s term Spinale Kinderlähmung (spinal infantile paralysis) and Medin’s work on poliomyelitis only referred to parts of the disease. Wickman’s term, however, was not to assert itself in the long run.
When in 1908, in Vienna, the discovery of the poliovirus by Karl Landsteiner
Karl Landsteiner
Karl Landsteiner , was an Austrian-born American biologist and physician of Jewish origin. He is noted for having first distinguished the main blood groups in 1900, having developed the modern system of classification of blood groups from his identification of the presence of agglutinins in the...
and Erwin Popper
Erwin Popper
Erwin Popper , was an Austrian physician, who, in 1908, along with Karl Landsteiner discovered the infectious character of Poliomyelitis....
was announced, Wickman did not give up his work as a clinical researcher and pediatrician. Neither did he join the Swedish team of clinical virologists. To him and his findings it did not make much difference, whether the polio agent was a virus or a bacterium.
Wickman’s legacy and posthumous honours
In the mean time, however, he has become recognized as a pioneer of polio research. In 1958 he was posthumously honoured by being inducted into the Polio Hall of Fame
Polio Hall of Fame
The Polio Hall of Fame consists of a linear grouping of sculptured busts of fifteen scientists and two laymen who made important contributions to the knowledge and treatment of poliomyelitis...
in Warm Springs
Warm Springs, Georgia
Warm Springs is a city in Meriwether County, Georgia, United States. The population was 478 at the 2010 census.-History:Warm Springs first came to prominence in the 19th century as a spa town, due to its mineral springs which flow constantly at nearly 32 °C...
, Georgia, USA. Third in line after Heine and Medin, followed by Landsteiner and eleven more polio experts and two laymen (one of them US-president Franklin D. Roosevelt
Franklin D. Roosevelt
Franklin Delano Roosevelt , also known by his initials, FDR, was the 32nd President of the United States and a central figure in world events during the mid-20th century, leading the United States during a time of worldwide economic crisis and world war...
), his bronze bust was revealed. Wickman’s classification of the different forms of polio is referred to by the European section of the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) as a “milestone” in polio eradication.
On the other hand, as late as 1971 polio expert and author John Rodman Paul still commented on Wickman’s impact: „Considering the importance of the contributions of Ivar Wickman, I do not believe that his work is fully appreciated today.“
Literature
- John R. Paul: A History of Poliomyelitis. Yale University Press, New Haven u.a. (Connecticut/USA) 1971 (= Yale studies in the history of science and medicine, 6), ISBN 0-300-01324-8, S. 88–97
- Hans J. Eggers, Milestones in Early Poliomyelitis Research (1840 to 1949), in: Journal of Virology, 73, 1999, S. 4533-4535
- Per Axelsson: Ivar Wickmans akademiska motgång - om en tjänstetillsättning och en akademiskt defekt, in: Läkartidningen, edited by Sveriges läkarförbund, 100, 2003.
- Per Axelsson: Höstens spöke. De svenska polioepidemiernas historia 1880-1965. Carlsson, Stockholm 2004 (= Diss. Umeå 2004), ISBN 91-7203-583-8 (Swedish); with abstract in English: The Autumn Ghost. The History of Polio Epidemics in Sweden.