Pieter Klazes Pel
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Professor Pieter Klazes Pel (February 22, 1852 in
Smallingerland Smallingerland (; fy, ) is a municipality in the province of Friesland in the Netherlands. Population centres Boornbergum, De Tike, De Veenhoop, De Wilgen, Drachten (main town), Drachtstercompagnie, Goëngahuizen, Houtigehage, Kortehemmen ...
– February 15, 1919) was a Dutch physician and professor of internal medicine.


Medical education

Pel attended the gymnasium at Sneek, then moved to study medicine in Leiden from 1869 to 1873. He became the assistant to one of his mentors, a Dr. Rosenstein, who was a professor of internal medicine at Leiden. Pel graduated cum laude in 1876. His doctoral thesis was entitled "The Fever Inducing Effect of Digitaline."


Career

In 1878 Pel was appointed "chef de clinique” at the University Hospital in Amsterdam, and devoted himself to internal medicine—both as a physician and as a researcher. In Pel's time, this meant all aspects of medicine besides surgery and gynecology; internal medicine was an extremely vast field. In 1880, Pel was appointed Lecturer in Contagious Diseases and Physiological Diagnostics. In 1883 he became a full Professor of Internal Medicine. In 1891 he was invited to go to Leiden University, but decided to stay in Amsterdam.


Notable contributions in medicine

Pel is perhaps best known for his description in 1885 of
Pel–Ebstein fever Pel–Ebstein fever is a rarely seen condition noted in patients with Hodgkin's lymphoma Hodgkin lymphoma (HL) is a type of lymphoma, in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated R ...
, a cyclical fever that occurs very rarely in individuals who have
Hodgkin's Lymphoma Hodgkin lymphoma (HL) is a type of lymphoma, in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated Reed–Sternberg cells (RS cells) are present in the patient's lymph nodes. The condition wa ...
. Pel described in the ''Berliner Klinische Wochenschrift'' the cases of two patients who had periods of fever for 12–14 days, alternating with about 10 days of fever-free periods. Pel noted on post-mortem examination
splenomegaly Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of ''hypersplenism'' which include: some reduction in number of circulating ...
(enlarged spleen) as well as swelling of the lymph nodes. In 1887, German physician
Wilhelm Ebstein Wilhelm Ebstein (27 November 1836, Jawor, Jauer, Prussian Silesia – 22 October 1912) was a German physician. He proposed a Low-carbohydrate diet, low-carbohydrate high-fat diet to treat obesity. Ebstein's anomaly is named for him. Biography ...
described a similar case in the same publication. A polemic between the two followed over whether this phenomenon was a symptom of what was then called "pseudo-leukemia" (Pel) or that of a separate disease (Ebstein). Pel also discovered what came to be called "Pel's crisis," defined as "Ocular crises in
tabes dorsalis Tabes dorsalis is a late consequence of neurosyphilis, characterized by the slow degeneration (specifically, demyelination) of the neural tracts primarily in the dorsal root ganglia of the spinal cord (nerve root). These patients have lancinating n ...
, characterized by neuralgic
paroxysmal Paroxysmal attacks or paroxysms (from Greek παροξυσμός) are a sudden recurrence or intensification of symptoms, such as a spasm or seizure. These short, frequent symptoms can be observed in various clinical conditions. They are usually ...
pains affecting the eyes and the ophthalmic area(s)." The term "Pel's crisis", however, is no longer commonly used, in favor of "tabetic ocular crisis". Pel shared the opinion of Sir
William Osler Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital. Osler created the first Residency (medicine), residency program for spec ...
, a contemporary of his, that the way to teach and train new physicians is at the bedsides of patients, rather than at a desk listening to lectures. Osler considered bringing students out of classrooms and into hospital wards—to learn by experience—to be his greatest legacy, and he is credited today as the father of the modern
medical residency Residency or postgraduate training is specifically a stage of graduate medical education. It refers to a qualified physician (one who holds the degree of MD, DO, MBBS, MBChB), veterinarian ( DVM or VMD) , dentist ( DDS or DMD) or podiatrist ( ...
. Pel gave his inaugural speech on the importance of bedside medical teaching, which serves as a good example of the level of importance he ascribed to the adoption of this practice. Additionally, Pel was quoted as saying, "Whereas, formerly, the sick patient functioned primarily as an example or illustration of the dominating theoretical education, in the modern world the careful, objective examination of the patient warrants priority attention." On a slightly different note, Pel was also quoted as saying, "When someone tells me that an animal on four feet is walking around in the yard next door, it could be a small tiger or elephant, but I still would rather think of a cat or a dog.” This quote is similar to a common anecdote that is still used in hospitals and medical schools—"When you hear hoofbeats, think horses—not zebras,"—and it is unclear whether the phrase quoted by Pel was originally his, or if he was reciting an adaptation of the modern common anecdote with zebras and horses.


References

{{DEFAULTSORT:Pel, Pieter Klazes 1852 births 1919 deaths Dutch infectious disease physicians People from Smallingerland Leiden University alumni Academic staff of the University of Amsterdam