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Mucoviscidosis Chopin a mukowiscydoza
Mucoviscidosis Chopin a mukowiscydoza 
| Did Chopin suffered from cystic fibrosis? |
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Fryderyk Franciszek Chopin lived from 1810? 1849. He was the greatest Polish composer and pianist. His work had an enormous influence on the music of the second half of the nineteenth and the twentieth century. Renowned artist was aware of the disease, which was reflected in his correspondence:? Suffers from the same disease as his sister, Emilia, was convinced that his life will be shorter as a result of the disease, the doctors who examined him did not know the nature of the disease, its music became a symbol of the tragedy of life?. Excerpts from the biography of Frederic Chopin marked by the stigma of the disease. The first 20 years of age. Frederick Chopin was born on March 1, 1810 in the village Zelazowa Wola. Father, Nicolas Chopin (1771 - 1844) was born in France at age 16 came to Polish and settled here permanently. Mother Tekla Justyna Krzyżanowski (1782 - 1861) came from Long in Kujawy. They had four children: daughters: Louise (1807? 1855), Isabella (1811? 1881) and Emilia (1813? 1827) and son Frederick. A few months after his birth the family moved to Warsaw, where Mikolaj Chopin was offered the post of lecturer at the Warsaw Lyceum, and ran a boarding school for sons of gentry. The diaries and personal letters we find references to the composer's health problems, which began in early childhood. Recurrent diarrhea, and symptoms from the gastrointestinal tract result in scarcity of body weight and delicate physique, this was accompanied by airway infections. In the years 1823-1826, Fryderyk attended the Warsaw Lyceum. During this time he suffered from tooth decay, biliousness type? Excess acid?, Headaches, frequent? A cold? and other illnesses. Caring for the Chopin, his doctor Gerardot cause any diet (among others. Coffee from roasted acorns, which is then used for gastrointestinal ailments, as well? The weight gain?), Periodic taking medication, bathing in wywarach strengthening of oak bark or acorns and Summer trips to the countryside. Status of fifteen young man truly reflect the notes of memories Wielisława:? Excessive growth, poorly built, with sunken chest ... big nose ... and often suffered severely on the teeth ... play in baseball and football ... he avoided every skating rink he fell and hurt his head and nearly zemdlonego are related to the house ... it recommended to drink a pint of wine in the water, slowly ...?. In winter, the composer had a 1826 years? Kataralną affection? with headache and fever, and the reaction in the surrounding lymph nodes, treated przystawianiem? leeches to the throat?. In spring and summer of 1826 years of Chopin's health deteriorated markedly: decreased body weight (by Dr. Malcza was strikingly thin), she appeared? Hyperactivity nervous and emotional?, Weakness, pallor and headache. He półtoramiesięczną Duszniki treatment, where used, among others. whey from goats' milk (in specific pulmonary diseases), Laubrunn, ie hipoosmotyczne Szczawa, inks - brine baths and long walks (on the larger mountains to climb had? banned?, and the smaller? złaził with reluctance, and sometimes on all fours?) . Treatment has not brought results. After returning to Warsaw chudł still, it is easy to zaziębiał constantly been forced to undergo the rigors of surgery. There is no tighter transfers that would attest to the fact that Chopin suffered severely in the following years, ie, before his departure from the Polish. It is likely that some friends or have working doctors, with whom Chopin has been in contact either directly or through their sons? peers and colleagues, gave him the appropriate advice or guidance. Life in exile - the first year. In November 1830 year, Chopin left Warsaw, going to Vienna, where he spent his eighth months, while remaining under the care of the imperial court physician Johann Malfatti. At that time, cold and long walk from the swollen nose. Treatment improved the Malfatti, in a letter to the family of his Chopin is surprised? Unexpectedly? good health and think malfatowskie soup is poured in? ... vein some lotion ....?. Chopin in Paris, he settled permanently in autumn 1831. Roommate composer (1832 - 1833) was Dr. Alexander Hoffman, who guarded primarily diet and proper rest. In 1832 Chopin wrote:? I have a whisker on one side? the other no longer grow?. From the spring of 1834 for the next six years the medical care of Dr. John Chopin exercised Matuszynski who could not have a proper effect on his brilliant friend. In the summer of 1835, Chopin visited for medical treatment in Karlovy Vary, which? Without strength? He returned to Paris. In November of that year had worsening health with fever, cough, hemoptysis course, since Chopin (counting only 25 years old) wrote a will, and to Warsaw reached a rumor that he died. For many months was strikingly gaunt, pale, and he had always grunted hoarseness. In February of 1837 years occurred in Chopin by his doctors treating bronchitis complicating? Flu? (High fever, hemoptysis occurred and vomiting blood, he was exhausted and apathetic). Despite several weeks of bed rest and collect potions constantly and desperately expectorant cough. Years of living with George Sand. For the first time Chopin met George Sand (1804? 1876), famous French writer, in October 1836. But after two years of close friendship was concluded. Already at the beginning of Chopin's health concerns in the wake of George Sand. In October of 1838 years the lovers went to Majorca. A few days after arrival in Chopin's health deteriorated. For the initial symptoms? Acute bronchitis? joined the haemoptysis, high fever with progressive weakness and not listed yet chest pain and hoarseness bordering aphonia. After a stop at the medical council of lying, a moderate diet, sliced gorczycznych (Emplastrum Sinapis), herbal medicines and warm zawijaniach chest. From 28 December 1838 years in Valdemosa lived in an abandoned Carthusian monastery. Chopin and coughed? Krząkał?, Was extremely thin and so weak that he could not leave the house. He often had abdominal pain and diarrhea, G. Sand reported that there were difficulties in finding suitable food for Chopin, because he was not greasy food served. During the return to Palma pulmonary haemorrhage occurred, which lasted intermittently for three days, and chest pain. Almost rescued a dying Chopin in Barcelona surgeon Jacques H. Poste. Before returning to Paris, George Sand and Chopin stayed three months in Marseilles. From Marseille, in a state of great weakness, Chopin went to George Sand in Nohant (where to spend long vacations up to 1846). The relationship of students that at the turn of 1839-1840 he was Chopin? Very suffering, poor .. coughed a lot?, in the classroom? been taking opium drops on sugar and water, rubber, rubbed her temples with cologne?, complained about the non-listed yet? chills febryczne?, on the face was always an expression of concern or pain and is still waiting for better health. In Chopin's observed? After the military raised arms? (Dyspnoe), poor dental health, digestive disorders, and extreme emaciation, expressing the weight only 44 kg at 170 cm tall. Stays in Nohant filled with spells of coughing and shortness of breath (by Dr. Papeta only reason? Excess mucus?). In the cold season condition of the composer's health deteriorated, asymptomatic periods were getting shorter. Chopin medical care over the years 1843? Doctor held in 1848, Jean Molin (1797-1848). Molina calls cause many complaints were different depending on the progressive pulmonary process. In subsequent years, cough and shortness of breath, have adopted a permanent asthma, in which overlapping orifice nasal catarrh, asthma attacks, zagrypienia, headaches, multiple recurrences of facial neuralgia. Cartoon by Paulina Virdot Chopin from 1844 shows that he was barrel chest and extremely thin legs. The last years of life. After the connection with G. Sand (July 1847), Chopin's health has deteriorated, increased problems with cough, difficulty of sputum, right-sided pain and nerve spasms in the chest, his body weight steadily decreased, there was depression. However, in April 1848, sickly Chopin went to London and Scotland. There, in spite of ill health (he often? Chained? To bed, had to be raised in the stairs) gave numerous concerts. Dr. Mallan desperate, gorączkującego and utterly exhausted, the composer? Wysztyftował? on his last concert on 16 November 1848 (for Polish immigrants in the Guildhall in London.) In November 1848 he returned to Paris. Since the beginning of 1849 he can hardly speak, and leave her bed. Often suffering from wrist pain, arm and ankle, had hemorrhages (probably massive hemoptysis), vomiting blood, diarrhea, swollen ankles and legs, was very exhausted. He sought new medical advice and hoped in spite of further disappointments. In early October 1849 he was not without support in a position to sit alone and had constant, severe attacks of dyspnoea productive cough with sputum and a trace of blood, large doses of opium were not able to stop it. The agony lasted four days. The composer died on the 17th Oct. 1849, to 2.00 in the morning. Dr. Cruveilhier confirmed death, an autopsy performed, and took heart. Death certificate gave the cause of death tuberculosis of the lungs and larynx. Autopsy results were lost. Records are preserved, however, citing the words of Dr. Cruveilhiera, in which he expresses the opinion that the death of Chopin's illness was caused by previously unknown to him. The health status of the family of Frederic Chopin Composer's mother enjoyed good health, died in the 77th century years. Father, Nicholas whole life he suffered from recurrent symptoms from the respiratory tract, died in his 73rd years due to lung disease and weakened heart. Of the three sisters of Frederick Chopin was not only Isabella health problems. The oldest sister Louise, she suffered from recurrent respiratory infections, she died at the age of 47 years. The youngest sister - Emily - was a delicate child, devastated by recurrent pneumonia, with continuous dyspnea, cough, hemoptysis, and krwistymi periodic vomiting, and significant deficiency of body weight. She had pulmonary disease beginning in childhood. She died in the 14th century years due to massive bleeding from the upper gastrointestinal tract. Family history of Frederic Chopin shows that two of the three sisters had serious health problems and died prematurely. These facts, combined with the disease suggest the possibility of Frederic Chopin in the family of Chopin hereditary disease and organ (symptoms from the following systems: respiratory and digestive tract). Kuzemko Chopin removed the tree, which testifies to the disclosure of inheriting the disease is autosomal recessive. Clinical symptoms and differential diagnosis of diseases of Frederic Chopin In Frederic Chopin found the following symptoms: Respiratory: cough, dyspnoea, haemoptysis distress, cyanosis, difficulty with coughing secretions, barrel-shaped chest; General: poor exercise tolerance, easy fatigability of muscles, low body mass, pallor, skin hyperpigmentation, peripheral edema, muscle atrophy, joint pains, headaches, neuralgia, depression, lack of hair on his face, infertility (never was the father in spite of living sexual assault, including 11 years of connection with George Sand); Gastrointestinal: chronic diarrhea, fatty food intolerance, vomiting blood. Some of these symptoms occurred for the first time at the age of ten years (probably earlier). Some of them suddenly and dramatically worse with age composer. Frederic Chopin occurring in clinical symptoms were attributed to different disease entities. Most of the doctors treating the composer felt that he is suffering from tuberculosis. In the contemporary literature of the authors supports this diagnosis. Few doctors Chopin (among others.: Gaubert, Cauviere and Papet) rule out TB. Raises doubts regarding the diagnosis result of the autopsy, which moved Cruveilhier professor, the author recognized to this day as an excellent textbook? Pathological anatomy of the human body?. Is this a distinguished pathologist at post mortem examination could not recognize tuberculosis? His opinion on the autopsy of Chopin - the death was caused by a disease previously unknown to him - points out that other than the diagnosis of tuberculosis. Among the proposed, but it seems unlikely diagnoses that arise in respect of sickness of Frederic Chopin, were taken into account: emphysema, bronchiectasis, hypogammaglobulinemię, allergic bronchopulmonary aspergillosis? Pulmonary, mitral stenosis, Churg-Strauss syndrome, chronic lung abscess, pulmonary hemosiderosis, pulmonary arteriovenous malformations? veins. Kuzemko in his work of 1994 sought to show that Chopin suffered from a lack of alpha 1? antitrypsin. Objected to this theory Majka et al (2003), arguing against such a diagnosis? the composer, there was no ascites and jaundice. Presented by the composer's clinical symptoms, a description of the section and the information from? Family history? speak for the diagnosis of cystic fibrosis. Previously, the diagnosis is also in the works Majka et al (2003) and O? Shea et al (1987). Cystic fibrosis is a disease that affects people from many thousands of years. In 1938, Dorothy Anderson used the first names:? Cystic fibrosis of the pancreas? (Cystic fibrosis of the pancreas), cystic fibrosis and identified as a distinct nosological entity. CF is characterized by a well-define:? Illness of many masks?. In the years of life of Fryderyk Chopin cystic fibrosis was not known, because of its identification with the composer as his life was impossible. Medical Diagnostics the first half of the nineteenth century was very poor. It was not possible to perform basic laboratory tests, microbiological testing (in the differential diagnosis of tuberculosis? Mycobacteria Koch - discovered in 1882), radiological (X-rays? Discovery in 1895). Since 1959 is used to identify cystic fibrosis, among others. jontoforezy non-invasive test developed by Gibson and Cook. In 1989 he isolated and characterized a gene, which determines the defect of the disease, the most common mutation detected F508a delta. That was the beginning of the molecular diagnostics of cystic fibrosis. There are now over 1000 mutations in the CFTR gene (Cystic fibrosis transmembrane regulator). Perhaps experiencing boom molecular diagnostics will help to bring a diagnosis of Frederic Chopin. There is a continuous progress in medical care for patients with cystic fibrosis, which must be conducted by teams of specialists: gastroenterologists, pulmonologists, ENT physicians, surgeons, physiotherapists, psychologists and pharmacologists. Antibiotics was first used in the treatment of patients with CF in 1949. Pancreatic preparations, initially used in powder form, and then beads revolutionized nutrition in patients with CF. Similar importance for the alleviation of pulmonary symptoms was the introduction of human DN-Asa. Isolated it for the first time in 1990 Shak et al These facts permit the conclusion that life of Frederic Chopin, the course of disease and its treatment would be immeasurably different if he lived in modern times. Some authors exclude a diagnosis of CF in Chopin due to the length of his life (39 years). The authors, despite the fact that before 1938 when the disease is discovered, the affected persons death before the age of 3 was 95%, the authors (like Majka et al) present a different view, the arguments given below. Cystic fibrosis may have a different expression - from mild to very severe. Currently, the average life expectancy of patients with CF is increasing and is above 30 years. However, it is very diverse and result from, among others. the type of mutation, the degree of expression of the disease and of treatment (as was probably in the nineteenth century). The oldest person affected by CF described is almost 70 year old woman with heterozygous mutations in the delta F508a. An increasing number of patients with CF who are diagnosed with the disease shortly after birth, and those whose diagnosis was late - after 16 years of age. This second case refers to patients with milder course of illness, more efficient in pancreas and lung disease with less intensity. No studies on the life expectancy of patients with late diagnosis of CF. Chopin probably suffered from mild or moderate form of cystic fibrosis in the course. At the time of his life has been significant attitude towards the disease. Tireless fight against chronic disease Chopin owed bytowym good conditions, lack of vices, loving care of parents first, and later G. Sand and long-term treatment (probably dealt with him the 34th doctor). On the therapy consisted of not only drugs but also aeroterapia (long stay in the country), posilna diet (oat, dairy, broths), strengthening the baths (Duszniki, Enghien and Marseille), treatments (leeches, plasma kata, massage) and the effect of heat (wrap the chest? three flannel trousers for?, staying at home), whey (donkey, cow and goat) and used in the last years of his life? lungwort?, or Icelandic moss (Cetaria islandica), containing a bacteriostatic effect similar to the Streptomycin. Was treated with opium and plant resources, and chemical-plant, ie naparami (tyzanny), extracts, and mineral waters? Rubber?, Miksturami,? Flakonami? to breathe? wykrztuśnym the action, soothing, and przeciwkrwotocznym przeciwkurczowym, calming, toning, and antipyretic przeciwpotnym, rozluźniającym locks. Despite the interest of many researchers - and biographers patografów - health-eminent composer, riddle, as Chopin was sick, remains unresolved. Probably a further step towards the explanation could be a molecular study. Source: Journal Cystic Fibrosis MATIO No. 1 (1931) / 2006 Authors: M. Szczepanik, M. Krawczynski, W. Cichy, N. Kobelska-Dubiel |