James Herrick (1861-1954): Consultant physician and cardiologist.

In 1910, James Bryan Herrick published the first clinical and laboratory description of sickle cell anemia. Two years later, he published a case report on coronary thrombosis. Together, these case reports solidified his reputation as one of the premier diagnosticians of his generation. Now regarded as a central figure in the history of American medicine, Herrick played an integral role in the clinical adoption of the electrocardiograph and the professionalization of cardiology in the United States. Although a full decade passed before the medical profession recognized his clinical description of coronary thrombosis and myocardial infarction, it has had profound implications for cardiovascular medicine and prevention over the past hundred years. As a consultant physician, Herrick advocated in favor of incorporating chemistry and laboratory evaluation into clinical practice.

The elusive clot: the controversy over coronary thrombosis in myocardial infarction.

UNLABELLED: After Heberden's description of patients with "angina pectoris" in 1768, for over 125 years most physicians believed that the disease was immediately fatal. The growing realization early in the twentieth century that in fact patients could survive an acute myocardial infarction led to a search for mechanisms and treatment. Coronary thrombosis was the primary candidate for the inciting event, but this supposition was based on rather piecemeal and uncritical reports. It became apparent that coronary thrombosis and acute myocardial infarction (AMI), terms that had often been used interchangeably, actually represented separate pathological entities. A few physicians even proposed that AMI caused coronary thrombosis rather than the other way around. The reasons for some investigators rejecting the coronary thrombosis hypothesis were ultimately shown to be the result of faulty pathological techniques and interpretations. This debate ended only when in vivo studies (i.e., coronary arteriography in living patients during AMI episodes) finally settled the matter. These events indicate that older theories, even when derived from faulty reasoning or poorly substantiated documentation, might ultimately prove valid. Newer investigative techniques can suddenly clarify issues that have previously seemed irresolvable. The identification of coronary thrombosis in AMI has led to major advances in the treatment of this serious and ubiquitous disease. KEYWORDS: coronary artery disease, coronary thrombosis, angina pectoris, acute myocardial infarction, coronary arteriography, anticoagulation.

2001 Torald Sollmann Award lecture. Looking toward the future, using lessons from the past.

It is a privilege and honor to be selected by the American Society of Pharmacology and Experimental Therapeutics for the Torald Sollmann Award. I wish to take this opportunity to comment on my experiences over the last 40 plus years as both a student and a faculty member. I was trained in pharmacology as well as medicine with the goal of entering an academic career that would permit me to engage in teaching and research. The subject of my presentation focuses on the events that helped to shape my career. Attention is given to those who made it possible for me to advance in my learning, teaching, and research. In addition to having been taught by excellent instructors, I have benefitted from having many outstanding undergraduate and graduate students, as well as postdoctoral fellows, without whom much of what I feel I have accomplished would not have been possible. Being surrounded by a supportive environment and accompanied by bright and eager young students gives me reason to look toward the future with enthusiasm. I chose to take the time and space allotted to me to present a brief overview of where I have been and how many individuals played important roles in helping to achieve my goals. In essence, this composition is a tribute to my family, professional associates, and current and former students.

Clarence Agress pioneers experimental thrombolysis of the coronary artery in 1952.

In 1952, Clarence Agress performed an experiment on dogs to demonstrate his idea that a thrombus in a coronary artery could be dissolved without harm to the myocardium. Although this landmark in cardiology has been forgotten, credit to Agress is deserved.