LAUSR

To the memory of Magdalena P. and all my patients with Huntington’s disease that I was unable to help as I wished. The nineteenth century was a time when specializations evolved from general medicine. General physicians, out of necessity dealing with the majority of their patients’ health problems, sometimes made important observations relevant to particular emerging specializations. For instance, a single article might unintentionally become an unquestioned and significant contribution to the development of a specific field of medicine. A good example in this context is George Huntington, the American family doctor after whom Huntington’s disease (or Huntington’s chorea) is named. George Huntington (Fig. 1) was born on April 9, 1850, in East Hampton on Long Island, New York, to a family with a rich medical tradition. He represented the third generation of physicians: his father, George Lee Huntington (1811–1881), had continued the medical practice opened by his own father, Abel Huntington (1777–1858). George Junior graduated from the Clinton Academy in his native town and, in 1868, began his medical studies at the College of Physicians and Surgeons at Columbia University in New York. In 1871, he qualified in medicine, with an inaugural dissertation on opium, at the age of 21. Shortly afterwards, he moved to Pomeroy in Ohio, where he began work as a family doctor [1]. On February 15, 1872, young Huntington traveled to the neighboring town of Middleport, Ohio. As it would turn out, the destination of that trip of a few miles was much farther: to a permanent place in the history of medicine. In front of the local medical society at the Meigs and Mason Academy of Medicine, a 22-year-old family doctor from a small town in the East of the United States, only 1 year after completing his medical graduation, with little clinical experience, gave a speech “On chorea”. Huntington must have been surprised by the significant difference he had noticed when comparing Sydenham’s chorea during his studies with those cases of chorea seen at his father’s practice. This probably explains why he chose to speak on chorea as a kind of welcome introduction to his new medical colleagues [2]. In his lecture, Huntington presented the clinical characteristics of chorea but, paradoxically, he dedicated the majority of the speech to discussing the symptomatology of Sydenham’s disease. Only in the final paragraphs did he specify the clinical features of the type of chorea later named after him: its hereditary nature, the onset occurring at “adult or middle life”, the predisposition to developing psychiatric symptoms, and a tendency to suicide. He also pointed out the steady progression of the disease, without any remission. At that time, he considered this form of chorea to be exclusive to Long Island and restricted “fortunately [to] a few families”; this was probably the reason he finished his lecture claiming that he only presented a “medical curiosity” with little practical significance. Time has shown how wrong he was in this opinion. The applause that followed the lecture prompted him to send his manuscript to The Medical and Surgical Reporter in Philadelphia, where it was printed only 8 weeks later, on April 13, 1872 [3]. This scientific report was noticed and published in the same year in the form of an abstract in the German medical press by Adolf Kussmaul (1822–1902) and Carl Nothnagel (1841–1905) in Jahresbericht or the Yearbook of Important Medical Writing for the Year 1872. Thus, was George Huntington’s name introduced into European medical literature [4]. The increasing recognition of the disease and, hence, growing interest in it contributed to further medical case reports that presented its clinical symptomatology consistent with Huntington’s own perception. In fact, the accurate and comprehensive characterization of chorea presented by George Huntington has become one of the classical descriptions of neurological diseases, and the reason the disease, in a period of eponyms, was named after this modest American physician. Several years later, in 1887, the designation “Huntington’s chorea” was coined by Huber [5]. But no man is an island. George Huntington had no patients of his own * Michał K. Owecki [email protected]