A binding question: the evolution of the receptor concept

In present-day pharmacology and medicine, it is usually taken for granted that cells contain a host of highly specific receptors. These are defined as proteins on or within the cell that bind with specificity to particular drugs, chemical messenger substances or hormones and mediate their effects on the body. However, it is only relatively recently that the notion of drug-specific receptors has become widely accepted, with considerable doubts being expressed about their existence as late as the 1960s. When did the receptor concept emerge, how did it evolve and why did it take so long to become established

'Patient trade' in Germany: an ethical issue at the practitioner-clinician interface in 1909 and 2009

In 2009 the German media featured the so-called ‘patient trade’ scandal. Offending against the rules of the professional code for German doctors, some medical practitioners had accepted bonus payments from specific hospitals for referring patients to them. This article discusses a historical precedent for this scandal, the patient trade affair of 1909, in which several medical professors of the Berlin university clinics were accused of having paid agents for bringing them lucrative private patients. Although the historical contexts were different, then, as in 2009, a commercial attitude towards medical practice clashed with the ethical ideal of the economically disinterested doctor

Doctors in Court, Honour, and Professional Ethics: Two Scandals in Imperial Germany

Comparing two public medical affairs which involved disciplinary proceedings and libel actions, one from Bavaria and one from Prussia, this article analyzes the dynamics behind legal conflicts over doctors’ professional ethics in Imperial Germany. In both the case of Dr Maurice Hutzler, who committed suicide after conflicts with senior colleagues at the Gisela Children’s Hospital and a sentence of the court of honour of the Munich Medical District Society, and the Berlin ‘patient trade’ affair, in which the medical professors Ernst von Leyden, Hermann Senator, Karl Anton Ewald and Carl Posner were accused of having made payments to middlemen for bringing them lucrative private patients, notions of personal and professional honour played a central role. The Munich case highlighted shortcomings of the Bavarian medical court of honour system, which was less developed than its Prussian counterpart. The analysis of the two cases suggests that the ethics of medical practice in early twentieth-century Germany should be viewed as part of a culture of honour

Historische Grundlagen des Rezeptor-Konzepts in der Pharmakologie *

In present-day pharmacology, the existence of specific cell receptors, which can combine chemically with drugs, poisons, neurotransmitters and hormones, is often taken for granted. However, until the 1960s receptors were controversial hypothetical entities. This article examines the initial experimental evidence for receptors that was produced and discussed between the 1870s and the 1930s. It is argued that pharmacologists were reluctant to adopt the receptor concept because of the indirect nature of the available experimental evidence, the competition with a physical theory of drug action and the fact that the idea of receptors had not originated from pharmacology itself, but from immunology and neurophysiology

Eine Kultur der Ehre: Ärztliche Berufsethik im Deutschen Kaiserreich zwischen Moral und Recht

English summary: Medical ethos in the sphere of influence of various non-medical interests is the focus of this anthology - an issue that is often neglected in the study of medicine and the history of medicine. Spectacular questions concerning medical successes and misdemeanours, daunting potentialities and borderline situations determine both historical studies and bioethical debate. The historical analyses of case studies from the fields of obstetrics and terminal care, notions of honour and medical duty in this volume aim to foster an awareness that even today must be maintained throughout medical training. This applies especially to questions concerning medical communication skills, the doctor-patient relationship, value orientation and a reflection on science, which are discussed in further contributions by experienced clinicians and theorists. The resulting portrayal of medical ethos depicts a core area of the study of medicine in terms of both its history and the demands made on medicine today. German description: Das ärztliche Ethos im Einflussbereich verschiedener aussermedizinischer Interessen steht im Fokus dieses Sammelbands - ein Thema, das in Medizingeschichte und -studium häufig vernachlässigt wird. Spektakulärere Fragen ärztlicher Erfolge und Vergehen, beängstigender Möglichkeiten und Grenzsituationen bestimmen sowohl historische Arbeiten als auch bioethische Debatten. Durch die historische Analyse von Fallbeispielen aus Geburtshilfe, Sterbebegleitung, zu Ehrbegriff und ärztlicher Selbstverpflichtung wird in diesem Band ein Problembewusstsein entwickelt, hinter das die ärztliche Ausbildung heute nicht zurückfallen darf. Das betrifft nicht zuletzt Fragen der ärztlichen Kommunikation, der Gestaltung der Arzt-Patient-Beziehung, der Werte-Orientierung und der Reflexion von Wissenschaft, auf die jeweils weitere Beiträge von erfahrenen Klinikern und Theoretikern eingehen. So entsteht ein Bild von ärztlichem Ethos, das für die Untersuchung der Medizin in ihrer Geschichtlichkeit wie in ihren aktuellen Anforderungen einen Kernbereich markiert

The Quantification and Differentiation of the Drug Receptor Theory, c. 1910-1960

While historians have dealt with the origins of the concept of drug receptors in the work of Paul Ehrlich (1854-1915) and John N. Langley (1852-1925) as well as with some of its applications in modern pharmaceutical research, the history of the receptor theory as such has been neglected. Discussing major developments and conceptual changes in receptor theory between about 1910 and 1960 (including relevant contributions by A. V. Hill, A. J. Clark, J. H. Gaddum, E. J. Ariëns and others), this paper attempts to fill this gap in historiography. It provides a case study of the unfolding of research under a new paradigm, but it considers also contemporary criticism and scepticism. By the early 1960s, quantitative investigations of drug action and interpretations of the experimental findings in terms of the receptor concept had become constitutive of the emerging field of 'molecular pharmacology'. Even then, however, receptors were still hypothetical entities