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Erythrocyte Sedimentation Rate (Esr) Essay

1022 words - 4 pages

Recently, in the Journal of Rheumatology in an interesting discussion concerning the application of ESR and CRP (C-reactive protein) appeared inaccurate information about the history of the discovery of ESR. Crowson, Rahman and Matteson in the article (1) and later in the discussion (2) suggested that the discovery of ESR occurred in the 20s of the last century. However, the discovery was not made in the 20s of the Twentieth Century, but at the end of the Nineteenth Century. For the sake of the highest standards of the discussion, in all its aspects, we would like to remind that the discoverer of erythrocyte sedimentation rate (ESR) was a Polish physician Faustyn Edmund Biernacki (1866-1911) (3,4,5,6,7). He announced the discovery in 1897 in two articles simultaneously: one written in Polish in Gazeta Lekarska (4) and the second in German in the Deutsche Medizinische Wochenschrift (5). It is also possible to identify, as an important historical fact, the exact day of Biernacki’s discovery. Shortly before the publication of works describing ESR, on the 22nd of June 1897 during a meeting of the Warsaw Medical Society Biernacki presented five most important conclusions from his observations (6,7). These conclusions were as follows: blood sedimentation rate and volume of residue produced is different in different individuals; blood with small amounts of blood cells sediments faster; blood sedimentation rate depends on the level of “fibrynogens” in the blood plasma; during the course of febrile diseases (rheumatic fever included) with large amounts of plasma fibrinogen the ESR is increased, and in the defibrinated blood the sedimentation process is slower. The findings presented by Biernacki clearly show the clinical significance of the discovery of ESR. They indicated sedimentary features of the plasma fibrinogen, which occurs in increased quantities in febrile disease. In 1906, Biernacki modified his method by using a capillary pipette of his own design called a microsedimentator instead of the originally used 20mm high cylinder. This technique allowed the determination of ESR after sampling of the capillary blood from the tip of the finger (6). As an anticoagulant he used a solution of sodium oxalate. Biernacki’s extremely successful research career was interrupted by his premature death (at the age of 45). In addition to describing the ESR he was also the discoverer of one of the symptoms of paretic dementia and the tabes dorsalis. What is more the neurological symptom, manifested by the analgesia of the ulnar nerve to oppression is referred to as the Biernacki’s symptom (7). In the 90’s of the nineteenth century, even before the discovery of ESR, Biernacki worked in Heidelberg, Giessen, Germany and Paris under the direction of Erba, Riegel, Charcot and Dejerine (6,7). Altogether, he published 98 scientific papers including experimental and theoretical ones, many of them devoted to the methodology of medical science and philosophy of medicine (6,...

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