Down syndrome historical perspective: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 7: Line 7:


==Historical Perspective==
==Historical Perspective==
 
* An English physician [[John Langdon Down]] first characterized Down syndrome as a distinct form of mental disability in 1862, and in a more widely published report in 1866 entitled "Observations on an ethnic classification of idiots".<ref>{{cite journal| author=Down, J.L.H.| year=1866| title=Observations on an ethnic classification of idiots| journal=Clinical Lecture Reports, London Hospital| volume=3| pages=259–262| url=http://www.neonatology.org/classics/down.html| accessdate = 2006-07-14}} For a history of the disorder, see {{cite book | title= John Langdon Down, 1828–1896 | author=OC Ward |publisher=Royal Society of Medicine Press | id=ISBN 1-85315-374-5|year = 1998}} or {{cite web| last=Conor| first=Ward |url =http://www.intellectualdisability.info/values/history_DS.htm| title =John Langdon Down and Down's syndrome (1828–1896)| accessdate = 2006-06-02}}</ref>  
English physician [[John Langdon Down]] first characterized Down syndrome as a distinct form of mental disability in 1862, and in a more widely published report in 1866 entitled "Observations on an ethnic classification of idiots".<ref>{{cite journal| author=Down, J.L.H.| year=1866| title=Observations on an ethnic classification of idiots| journal=Clinical Lecture Reports, London Hospital| volume=3| pages=259–262| url=http://www.neonatology.org/classics/down.html| accessdate = 2006-07-14}} For a history of the disorder, see {{cite book | title= John Langdon Down, 1828–1896 | author=OC Ward |publisher=Royal Society of Medicine Press | id=ISBN 1-85315-374-5|year = 1998}} or {{cite web| last=Conor| first=Ward |url =http://www.intellectualdisability.info/values/history_DS.htm| title =John Langdon Down and Down's syndrome (1828–1896)| accessdate = 2006-06-02}}</ref> Due to his perception that children with Down syndrome shared physical facial similarities ([[epicanthal fold]]s) with those of Blumenbach's Mongolian race, Down used terms such as ''mongolism'' and ''Mongolian idiocy''.<ref>{{cite journal|Author =Conor, W.O.| year =1999| title =John Langdon Down: The Man and the Message| journal =Down Syndrome Research and Practice| volume =6| issue =1| pages =19–24| accessdate = 2006-06-02}}</ref>  Down wrote that mongolism represented "retrogression," the appearance of Mongoloid traits in the children of allegedly more advanced Caucasian parents.
* When John Down was 18 years old, he met a girl that appeared so odd and peculiar, that he felt sorry for her and, consciously or unconsciously, would spend the rest of his life deciphering and studying about what led to such a behavior and appearance in human beings. He decided to study Medicine, became the director of the largest “Asylum for Idiots” in England and became the pioneer of medical literature about the phenomena that he found so intriguing.
 
* Based on antropometric measurements and photographic appearance, he delineated a well-defined group of mentally disabled individuals, whose members all resembled the little girl very well. He called them, in concordance with the ethnical insights of the then famous dr. Blumenbach, mongoloid “idiots”. Today they are known by his own, more ethically correct name: Down's syndrome.
By the 20<sup>th</sup> century, "Mongolian idiocy" had become the most recognizable form of mental disability. Most individuals with Down syndrome were institutionalized, few of the associated medical problems were treated, and most died in infancy or early adult life. With the rise of the [[eugenics]] movement, 33 of the (then) 48 U.S. states and several countries began programs of involuntary sterilization of individuals with Down syndrome and comparable degrees of disability. The ultimate expression of this type of public policy was the German [[euthanasia]] program "Action T-4", begun in 1940. Court challenges and public revulsion led to discontinuation or repeal of such programs during the decades after World War II.
By the 20<sup>th</sup> century, "Mongolian idiocy" had become the most recognizable form of mental disability. Most individuals with Down syndrome were institutionalized, few of the associated medical problems were treated, and most died in infancy or early adult life. With the rise of the [[eugenics]] movement, 33 of the (then) 48 U.S. states and several countries began programs of involuntary sterilization of individuals with Down syndrome and comparable degrees of disability. The ultimate expression of this type of public policy was the German [[euthanasia]] program "Action T-4", begun in 1940. Court challenges and public revulsion led to discontinuation or repeal of such programs during the decades after World War II.



Revision as of 20:19, 17 March 2018

Down syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Down syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Sociological and Cultural Aspects

Case Studies

Case #1

Down syndrome historical perspective On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Down syndrome historical perspective

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Down syndrome historical perspective

CDC on Down syndrome historical perspective

Down syndrome historical perspective in the news

Blogs on Down syndrome historical perspective

Directions to Hospitals Treating Down syndrome

Risk calculators and risk factors for Down syndrome historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Down syndrome (Trisomey 21 or Dow's syndrome) is a genetic disorder is characterized by the presence of all or part of an extra 21st chromosome.[1] John Langdon Down, a British doctor described it first in 1866. Jérôme Lejeune in 1959 ascribed the features associated with Down's syndrome to the presence of an extra 21st chromosome (trisomy 21).

Historical Perspective

  • An English physician John Langdon Down first characterized Down syndrome as a distinct form of mental disability in 1862, and in a more widely published report in 1866 entitled "Observations on an ethnic classification of idiots".[2]
  • When John Down was 18 years old, he met a girl that appeared so odd and peculiar, that he felt sorry for her and, consciously or unconsciously, would spend the rest of his life deciphering and studying about what led to such a behavior and appearance in human beings. He decided to study Medicine, became the director of the largest “Asylum for Idiots” in England and became the pioneer of medical literature about the phenomena that he found so intriguing.
  • Based on antropometric measurements and photographic appearance, he delineated a well-defined group of mentally disabled individuals, whose members all resembled the little girl very well. He called them, in concordance with the ethnical insights of the then famous dr. Blumenbach, mongoloid “idiots”. Today they are known by his own, more ethically correct name: Down's syndrome.

By the 20th century, "Mongolian idiocy" had become the most recognizable form of mental disability. Most individuals with Down syndrome were institutionalized, few of the associated medical problems were treated, and most died in infancy or early adult life. With the rise of the eugenics movement, 33 of the (then) 48 U.S. states and several countries began programs of involuntary sterilization of individuals with Down syndrome and comparable degrees of disability. The ultimate expression of this type of public policy was the German euthanasia program "Action T-4", begun in 1940. Court challenges and public revulsion led to discontinuation or repeal of such programs during the decades after World War II.

Until the middle of the 20th century, the cause of Down syndrome remained unknown. However, the presence in all races, the association with older maternal age, and the rarity of recurrence had been noticed. Standard medical texts assumed it was caused by a combination of inheritable factors which had not been identified. Other theories focused on injuries sustained during birth.[3]

With the discovery of karyotype techniques in the 1950s, it became possible to identify abnormalities of chromosomal number or shape. In 1959, Professor Jérôme Lejeune discovered that Down syndrome resulted from an extra chromosome.[4] The extra chromosome was subsequently labeled as the 21st, and the condition as trisomy 21.

In his last years, Professor Lejeune did research into the question of metabolic abnormalities in persons with Down Syndrome. After his death in 1994, his research has been continued by Dr. Paddy Jim Baggot. Some success at identifying abnormalities and finding treatments has been experienced. In later research, it has been shown that measures to treat biochemical deficiencies should begin at about the 22nd week of pregnancy. Some parents are currently giving supplements to their children with Down Syndrome, which has resulted in some improvement of their capabilities. [5]

Naming

In 1961, nineteen geneticists wrote to the editor of The Lancet suggesting that Mongolian idiocy had "misleading connotations," had become "an embarrassing term," and should be changed.[6] The Lancet supported Down's Syndrome. The World Health Organization (WHO) officially dropped references to mongolism in 1965 after a request by the Mongolian delegate.[7] However, almost 40 years later, the term ‘mongolism’ still appears in leading medical texts such as Review of Medical Physiology, 22nd Edition, 2005, by Professor William Ganong and General and Systematic Pathology, 4th Edition, 2004, edited by Professor Sir James Underwood.

In 1975, the United States National Institutes of Health convened a conference to standardize the nomenclature of malformations. They recommended eliminating the possessive form: "The possessive use of an eponym should be discontinued, since the author neither had nor owned the disorder."[8] Although both the possessive and non-possessive forms are used in the general population, Down syndrome is the accepted term among professionals in the USA, Canada and other countries; Down's syndrome is still used in the United Kingdom and other areas.[9]

References

  1. "Trisomy 21: The Story of Down Syndrome paper".
  2. Down, J.L.H. (1866). "Observations on an ethnic classification of idiots". Clinical Lecture Reports, London Hospital. 3: 259–262. Retrieved 2006-07-14. For a history of the disorder, see OC Ward (1998). John Langdon Down, 1828–1896. Royal Society of Medicine Press. ISBN 1-85315-374-5. or Conor, Ward. "John Langdon Down and Down's syndrome (1828–1896)". Retrieved 2006-06-02.
  3. Warkany, J. (1971). Congenital Malformations. Chicago: Year Book Medical Publishers, Inc. pp. 313–314. ISBN 0-8151-9098-0.
  4. "Jérôme Lejeune Foundation". Retrieved 2006-06-02.
  5. "The Michael Fund".
  6. Gordon, Allen (1961). "Mongolism (Correspondence)". The Lancet. 1 (7180): 775. Unknown parameter |coauthors= ignored (help)
  7. Howard-Jones, Norman (1979). "On the diagnostic term "Down's disease"". Medical History. 23 (1): 102–104. PMID 153994.
  8. A planning meeting was held on 20 March 1974, resulting in a letter to The Lancet."Classification and nomenclature of malformation (Discussion)". The Lancet. 303 (7861): 798. 1974. The conference was held 10 February-11 February 1975, and reported to The Lancet shortly afterward."Classification and nomenclature of morphological defects (Discussion)". The Lancet. 305 (7905): 513. 1975.
  9. Leshin, Len (2003). "What's in a name". Retrieved 2006-05-12.

Template:WH Template:WS