Abstract
Medical mycology is a relatively young sub-discipline of medicine, institutionalized principally after the Second World War. In this paper, I will trace the process leading to the establishment of medical mycology in the United States, United Kingdom and Japan, three of the most important players in the International Society for Human and Animal Mycology (ISHAM) today. Throughout the paper, I will highlight both common features and the unique trajectory found in each country. The latter point resulted from the relative emphasis placed upon certain phenomena in each country. In the US, it was environmental conditions, tradition of soil sciences and particular settings of public health, which all created a stage for medical mycology. In Britain, among many medical specialists involved in building a society for medical mycology, contributions of those in tropical medicine and veterinary science stood out, and after the war, studies of allergy and bronchopulmonary aspergillosis and participation of the MRC were decisive. In Japan, concrete reports on visceral candidiasis and the so-called Bikini Incident were critical determinants. It appears that, although medical mycology emerged almost concomitantly in the three countries, the paths taken were different, thus seemingly the origins and pathways of modern medical mycology in each country ought to be understood in terms of broader historical themes.
Notes
1. See Reference 1, p. 194.
2. For historical works that deal with the issue of specialization of medicine, see, for instance, Weisz, Stevens and Rosen from the list below.
3. See Reference 5, pp. 9–22.
4. For San Joaquin Valley fever, see Reference 5, pp. 130–142 and Reference 10, pp. 283–291.
5. For biographies of Emmons, see Reference 5, p. 45 and Kwong-Chung and Campbell from the list below.
6. For the concept of ‘Formative Years’, see Reference 5, pp. xiv–xv.
7. From the immediate post-war, US Public Health Service included the section on the mortality from fungous infection in their special reports on vital statistics. See below for references.
8. Conant had initially been offered to direct the CDC unit once the decision was made to move the laboratory to Atlanta, but he declined it as he did not wish to leave North Carolina. The author thanks one of the anonymous referees for this information.
9. See Reference 14, p. 763.
11. Immediately, however, Kligman challenged this view. Kligman's claim, it turned out, was not sustained by a majority, but seemingly one that was absorbed into the important debate over the technique to culture pathogenic fungi. See below for reference.
12. However, this did not necessarily yield to the extinction of the study of fungal diseases in laboratory science. In Britain, it seemingly survived in pathology, whereby morbid anatomy of lung, for instance, resulted in a number, albeit small, of descriptions on aspergillosis. See, for instance, Arkle, Boyce and Wheaton below.
13. See Reference 3, p. 154.
14. Members of the MRC's Medical Mycology Committee were Dr J. T. Duncan (Chairman), Prof. L. P. Garrod, Mr A. M. H. Gray, Dr I. Muende, Dr J. Ramsbottom, Dr A. H. T. Robb-Smith, Dr R. St. John-Brooks, Prof. M. J. Stewart, Dr Sydney Thompson, Dr S. P. Wiltshire, Dr P. H. Gregory (Secretary).
15. For instance, in the closing section, Duncan remarked: ‘It is significant, however, that the pathologist concerned is deeply interested in medical mycology, and no fungous disease escapes his attention’. Emphasis added. See Reference 38, p. 718. For the early English literature on pathological investigation of fungal infection of the lung, see Bennett from below.
16. This does not mean that there was no equivalent in North America. In fact, already over a decade prior to the MMC publication, in 1935 Carroll W. Dodge published a seminal 900-page monograph titled Medical Mycology: Fungous Diseases of Men and Other Animals, in which she described over 4,000 references of pathogenic fungi.
17. See Reference 52, p. 393.
18. See Reference 55, p. 43.
19. For more details, see the BMSS's website http://www.bsmm.org/main.htm.
20. Aside from the lecture courses mentioned here, the Institute of Dermatology at St. John's Hospital for Diseases of the Skin was also providing pathologists and dermatologists with regular courses. See Reference 3, pp. 131–134.
21. Gakoso can be literally translated as ‘pox on goose's mouth’, for allegedly a lump attached to the joint end of a goose's beak appeared similar to the symptom of oral thrush.
22. See Reference 63, p. 4.
23. See Reference 4, p. 238.
24. Members of the Research Committee of Hyphomycoses were: Yoshisada Takahashi (chairman); Choichiro Akiba; Toshiro Goto; Osamu Miura; Hitoshi Miyake; Takeshi Tsuchiya; Kentaro Higuchi; Atsuhiko Kitamura; Seiichi Kitamura; Yoshio Mikamo; Shigeo Okinaka; Takehito Takuma.
25. For a list of publications, see Takahashi from below.
26. The decision was partly informed by a tendency towards the study of candidiasis, following initial reports by Donomae, Mikamo and Kakinuma. In fact, the Committee, although its main scope was on dermatophytes, also covered Candida. In the report of the Committee, he wrote, ‘today, it is Candida spp. as well as dermatophytes for which we are rendered to come up with resolutions urgently’. See Reference 66, p. 549.
27. Members of the Research Committee of Candidiasis were: Imasato Donomae (Chairman); Tsunesaburo Fujino, Takeshi Tsuchiya and Kaoru Urabe (bacteriology and serology); Hitoshi Miyake (pathology); Yoshio Mikamo, Shingo Aoyama and Imasato Donomae (internal medicine); Atsuhiko Kitamura, Yoshisada Takahashi, Osamu Miura, Kentaro Higuchi, Seiichi Kitamura (dermatology); Toshiro Goto (otolaryngology); Shigemitsu Mizuno (obstetrics).
28. In later years, Juntendo also welcomed Hideo Ikemoto, who, since 1955, published prolifically on medical mycology. For an example of his earlier work, see Ikemoto from below.
29. However, as in other countries, in Japan, too, fungi were a subject of interest among medical men, whose successors established bacteriology. See Fujino and Bulloch below for more details.
30. See Reference 4, p. 170.
31. See Reference 54, for example, for a report on pulmonary aspergillosis during the period.