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Dermatopathology: Practical & Conceptual

July – September 2010 | Volume 16, No. 3

Historical examples

Jargin, Sergei V.

Introduction

Previously we reported several cases of plagiarism from the former Soviet Union where entire chapters of medical handbooks were copied verbatim or shortened from English-language editions and published in Russian without reference to the source. [1,2] Here we present examples of plagiarism and incorrect quotations from the history of pathology. The source of borrowing of all examples presented here was the Handbuch der Speziellen Pathologischen Anatomie und Histologie edited by Friedrich Henke and Otto Lubarsch, published by Julius Springer in Berlin (volume 4 part 2 edited in1928 and volume 6 part 1 edited in 1930). [3-5] The borrowings were found in the chapter on pathology of the stomach, written by Yuli M. Lazovski and in the chapter on pathology of the liver, written by Alexey I. Abrikosov, in the Handbook of Pathological Anatomy in Many Volumes (editor: A.I. Strukov; editor of the volume on pathology of the digestive organs A.I. Abrikosov), published by Medgiz in Moscow in 1957. [6,7]

Example 1

The text in German on the stomach lesions in congenital syphilis on pages 1017-1018 of volume 4, part 2 in Handbuch der Speziellen Pathologischen Anatomie und Histologie [3] (Figs. 1-2) reads as follows:

“Nach der mikroskopischen Untersuchung war in allen Fällen der Hauptsitz der Erkrankung und Gewebsneubildung in der Unterschleimhaut festzustellen. Sichere miliare Gummen (Granulations-Zellhaufen mit zentraler Nekrose) beschrieben Aristoff, Pater und Oberndorfer. Während Pater das Fehlen von Gefäßveränderungen hierbei hervorhebt, beteiligen sich nach Oberndorfer, der wohl die ausführlichste histologische Beschreibung gibt, die Gefäße lebhaft an der Neubildung. Ihre Adventitia zeigte beträchtliche Auflockerung und Wucherung, seltener war eine Intimawucherung bis zur Verödung vorhanden. Nach Oberndorfer ist der Ausgangspunkt der Zellwucherung in der Gefäßadventitia zu suchen. Er fand in seinem Falle im Bereich der bis erbsengroßen Erhebungen eine ziemlich umschriebene Verdickung der Submucosa durch reichlich um erkrankte Gefäße liegendes Granulationsgewebe, in dem Knötchen von epitheloiden Zellen mit zentraler Nekrose vorhanden waren. Die Muscularis mucosae war in einigen Magenknoten erhalten, in anderen unterbrochen. Durch diese Bresche strahlte das Granulationsgewebe in die Schleimhaut aus. In der verbreiterten Mucosa fanden sich zahlreiche Granulationszellnester, welche verdickte teilweise verödete Gefäße einschlossen, an einzelnen Stellen mit beginnendem Zerfall im Inneren. Der Bau der Schleimhaut war in den geschwürigen Herden fast vollständig zerstört… Die Muscularis propria und die Serosa wiesen weder Zellvermehrung noch Verdickung auf.”

This text can be translated into English as follows:

“Microscopically, the main location of the pathological changes and of the newly formed tissue in all cases was the submucosa. Unequivocal miliary gummas (collections of granuloma cells with central necrosis) were described by Aristoff, Pater and Oberndorfer. Pater pointed out the absence of vascular changes; but according to Oberndorfer (who provided probably the most detailed histological description) blood vessels vividly participate on the new formation. The adventitia showed considerable loosening and excrescence but the overgrowth of the intima up to the lumen obsolescence was rarer. According to Oberndorfer, the starting point of cellular proliferation must be searched within the vascular adventitia. He found in his case, in the area of up to pea-sized elevations, a rather well delimited thickening of the submucosa caused by abundant granulation tissue formed around pathologically changed blood vessels. Nodules of epithelioid cells with central necrosis were present in the granulation tissue. The muscularis mucosae was preserved in some gastric nodules, but interrupted in other ones. Granulation tissue radiated through these breaches into the mucosa. In the widened mucosa, numerous foci of granulation cells were found around thickened and partly obsolete blood vessels, in some places with beginning decomposition inside. The structure of the mucosa was almost completely destroyed within the foci of ulceration… The muscularis propria and serosa showed neither increased cellulation nor thickening.”

The text by Lazovski from page 390 of the handbook [6] is shown in Figure 3. It can be translated thus:

“Specific gastric changes in congenital syphilis are mainly represented by development of granulation tissue in the submucosa, where typical miliary gummas with central necrosis can be found. Last time, special attention has been drawn to the involvement of blood vessels into the process. In the considerably loosened venous adventitia appear numerous cellular infiltrates composed of lymphocytes, plasma cells, and histiocytes; rarer is the overgrowth of the intima with a narrowing or obsolescence of the lumen. . . . The muscularis mucosae is preserved in some places, but interrupted in other ones. Granulation tissue radiates through these breaches into the mucosa. Thus in the widened mucosa appear numerous foci consisting of granulation tissue and obliterated vessels. In these foci, necrobiotic changes are consequently developing, and therefore structure of the mucosa is destroyed, and the mucosa becomes ulcerated. The gastric muscularis propria and serosa are less affected.”

Figs. 1 and 2

Stomach lesions in congenital syphilis. Reproduced from Handbuch der Speziellen Pathologischen Anatomie und Histologie, 1928. [3]

Fig. 3

Stomach lesions in congenital syphilis. Reproduced from the Mnogotomnoe rukovodstvo po patologicheskoi anatomii [Handbook of pathological anatomy in many volumes],1957. [6]

Example 2

The text on the stomach ulcers and scars in syphilis on pages 1024-1025 of volume 4, part 2 of Handbuch der Speziellen Pathologischen Anatomie und Histologie [3] (Figs. 4-5) reads as follows:

“Einfache Ulzera und Narben

Ganz ähnlich wie bei den chronischen Gastritis liegen die Dinge in den Fällen, in welchen bei Syphilitischen einfache typische chronische Ulzera und Narben im Magen gefunden worden sind. Bekanntlich hat ja Cruveilhier die Meinung ausgesprochen, daß wenigstens ein Teil der einfachen Magengeschwüre syphilitischen Ursprungs ist. Auch Galliard glaubt, daß viele Ulcera rotunda auf syphilitischer Grundlage (syphilitische Gefäßerkrankungen) entstehen. Nach Lang sollen 29 % aller Magengeschwüre auf Syphilitische entfallen. Diese Feststellung ist vielfach in dem Sinne bewertet worden, daß Magengeschwüre bei Syphilitischen besonders häufig sind. … Chiari hat unter seinen 97 Fällen von erworbener Syphilis … nur einmal ein einfaches Magengeschwür und in dem gleichen Fall eine augenscheinlich auf ein solches Ulcus zu beziehende Narbe… “Der Magen syphilitischer Individuen ist gewiß nicht häufiger als der anderer Personen Sitz von peptischen Ulzerationen oder darauf zu beziehender Narben.’ “

This text can be translated as follows:

“Simple ulcers and scars

The issue of typical simple ulcers and scars in the stomach of a syphilitic patient is analogous to that of the chronic gastritis. Cruveilhier pointed out that at least a part of simple stomach ulcers are of syphilitic nature. Also Galliard believes that many round ulcers appear on the basis of syphilis (syphilitic vascular disease). According to Lang, 29 % of all stomach ulcers must be found in syphilitics. This statement should be valued largely in the sense that stomach ulcers are especially frequent in syphilitic patients. . . . Chiari had among his 97 cases of acquired syphilis only 1 stomach ulcer and in the same case a scar obviously related to such an ulcer . . . ‘The stomach of a syphilitic individual houses peptic ulcers or scars related to the ulcers certainly not more frequently than that of other persons.’ “

The text by Lazovski from the pages 391-392 of the handbook [6] is shown in Figures 6 and 7. It can be translated thus:

“Simple ulcers and scars

The issue of their syphilitic nature is discussed since the time of Cruveilhier. He first pointed out that a part of chronic stomach ulcers should be put in connection with syphilis. This opinion was later supported by some authors, who stated categorically that a chronic gastric ulcer is a frequent expression of the syphilitic infection (according to Lang, 20 % of all stomach ulcers are of syphilogenic origin). After the Chiari’s work, who determined that chronic stomach ulcers in syphilitics are not more frequent than in other patients, such statements started already to acquire historical interest.”

Figs. 4 and 5

Stomach ulcers and scars in syphilis. Reproduced from Handbuch der Speziellen Pathologischen Anatomie und Histologie, 1928. [3]

Figs. 6 and 7

Stomach ulcers and scars in syphilis. Reproduced from Mnogotomnoe rukovodstvo po patologicheskoi anatomii [Handbook of pathological anatomy in many volumes], 1957. [6]

Example 3

Werner Gerlach comments on the page 82 of volume 6, part 1 in Handbuch der Speziellen Pathologischen Anatomie und Histologie [4] about liver hyperemia (Fig. 8):

“Die alltägliche Form der aktiven Leberhyperämie, die den Klinikern seit langem bekannt , für den Physiologen eine Selbstverständlichkeit ist, dem Pathologen aber nicht zu Gesicht kommt, ist die Verdauungshyperämie der Leber … kann sie pathologisch gesteigert und verlängert sein, ja zu einem Dauerzustand werden durch die Aufnahme von Spirituosen, durch reichliche Flüssigkeitsaufnahme, durch scharf gewürzte Speisen.”

This text can be translated as follows: “The usual form of active liver hyperemia, well known by clinicians and an obvious thing for a physiologist, but not encountered by a pathologist, is a digestive liver hyperemia. . . . It can be physiologically enhanced and prolonged, and even become a permanent condition, because of alcohol consumption, abundant intake of fluids, and spicy food.”

The text Abrikosov from page 228 of the handbook [7] is shown in figure 9. It can be translated thus: “Active liver hyperemia is not always reliably determined by autopsy. Clinicians and experimenters are however well acquainted with the rapidly developing and usually transient liver hyperemia. So, one can speak about digestive liver hyperemia that develops at a certain phase of digestion, especially after consumption of spicy food and alcohol . . . “

Fig. 8

Liver hyperemia. Reproduced from Handbuch der Speziellen Pathologischen Anatomie und Histologie,1930. [4]

Fig. 9

Liver hyperemia. Reproduced from Mnogotomnoe rukovodstvo po patologicheskoi anatomii [Handbook of pathological anatomy in many volumes], 1957. [7]

Example 4

Gotthold Herxheimer comments on the page 938 and further on the page 944 of volume 6, part 1 of Handbuch der Speziellen Pathologischen Anatomie und Histologie [5] about cavernous hemangioma of the liver (Figs. 10-11):

“Mikroskopisch bestehen die Kavernome aus Bluträumen, deren Wand zunächst ( . . . ) aus mit Endothel bekleideten dünnen bindegewebigen Scheidewänden besteht. In dem Bindegewebe finden sich hie und da auch glatte Muskelfasern, worauf schon Virchow hinwies, und ferner elastische Fasern, zunächst in mäßiger Menge.”

“Aus allen diesen neueren Behandlungen der Leberkavernome dürfen wir also wohl mit Sicherheit schließen, daß diese zunächst als Anlagefehler aufzufassen sind, aus fötaler oder postfötaler Zeit, und daß wir sie mit Recht als Hamatrome oder Hamartien bezeichnen dürfen. Schließen sich echte Geschwülste an, so kann man auch von Hamartoblastomen sprechen.”

These two text fragments can be translated as follows:

“Microscopically, the cavernomas consist of spaces filled with blood with the walls formed primarily by thin fibrous septa covered by endothelium. In connective tissue can be seen here and there smooth muscle fibers, pointed out already by Virchow, and furthermore also elastic fibers, first time in a moderate quantity.”

“From all that newer handling of liver cavernoma we can with certainty conclude that it should be primarily understood as a malformation from the fetal or post-fetal period, and that we can rightly designate it as a hamartoma or hamartia. Should a true neoplasm come in addition, it can be referred to as hamartoblastoma.”

The corresponding text fragments by Abrikosov from the pages 371 and 373 of the handbook [7] are shown in the figures 12 and 13. The fragments can be translated thus:

Microscopically, the septa between the blood- filled spaces are formed of fibrous tissue with elastic fibers; sometimes with visible admixture of smooth muscle cells; the spaces are covered with endothelium.

Finally, some cavernomas result from malformation of hepatic tissue (Briukhanov), or from a separation, chorista, of vascular tissue, or hamaria in the sense of an excessive development of blood vessels in the hepatic tissue; in case of a considerable growth of such choristas and hamartias one can speak about choristomas and hamartomas . . . A possibility is not excluded that a vascular hamartoma acquires the properties of a true neoplasm, which is named hamartoblastoma.

Figs. 10-11

Cavernous hemangioma of the liver. Reproduced from Handbuch der Speziellen Pathologischen Anatomie und Histologie, 1930. [5]

Figs. 12-13

Cavernous hemangioma of the liver. Reproduced from Mnogotomnoe rukovodstvo po patologicheskoi anatomii [Handbook of pathological anatomy in many volumes], 1957. [7]

Example 5

The last example refers to transliteration of the foreign authors’ names in the Cyrillic alphabet with misspellings at times making even approximate phonetic reproduction impossible. Figure 14 represents a quotation in the text written by Abrikosov, where the names of the foreign authors are given in Cyrillic letters without initials. The same in Latin letters would be: “Ribbert, Rössle, Gerlach, Hagerty, Devereux, A.I. Abrikosov.” [7] Note that some names (e.g., Devereux in Fig. 14) are crassly misspelled. Figure 15 shows the same name in the reference list. Figure 16 shows the title page of this volume. Figure 17 shows the title page of Handbuch der Speziellen Pathologischen Anatomie und Histologie. [3]. Figures 16 and 17 illustrate a psychological phenomenon of the phobic type. Abrikosov was a prominent Soviet functionary and the librarians were not permitted to stamp or write on the title page of the book; all stamps and handwritten notices were made on the following page. This mechanism didn’t work in case of the classical foreign edition, which is a bibliographical rarity in the former Soviet Union.

Fig. 14

Example of quotation by Abrikosov: “Ribbert, Rössle, Gerlach, Hagerty, Devereux, A.I. Abrikosov.” Some of the foreign names are misspelled in Cyrillic alphabet, making a correct phonetic reproduction impossible. Reproduced from Mnogotomnoe rukovodstvo po patologicheskoi anatomii [Handbook of pathological anatomy in many volumes], 1957. [7]

Fig. 15

A fragment of the reference list from [7] containing the author’s name I.W. Devereux misspelled in Cyrillic letters as shown in the Fig. 8. Note that the pages of journal articles and of chapters in handbooks are not indicated, which makes it difficult if not impossible to find the quoted sources. Journal issues also are not always indicated.

Fig. 16

The title page of the edition. [7] Librarians were not permitted to stamp or write on the title page of the book; all stamps and handwritten notices were made on the following page.

Fig. 17

The title page of the edition [3]. Librarians stamped and wrote on the title page of the classical foreign edition, which is a bibliographical rarity in the former Soviet Union.