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When was Mesothelioma Discovered

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Despite its perceived magical properties, people noticed early on that exposure to asbestos could be dangerous. Roman historian and doctor Pliny the Elder (23AD to 79 AD) warned that slaves who worked in asbestos mines suffered disproportionally from serious lung ailments. He argued that it was risky to buy a slave that worked in these mines because they died young.<ref>Tannapfel, <i>Malignant Mesothelioma</i> at p. 2</ref> Plinny's observation was remarkably prescient, but medicine was not able to diagnosis what was causing this malady for almost 2000 years. Mesothelioma resisted being diagnosed because the tumors associated with it were easily confused with tuberculous.<ref>Tannapfel <i>Malignant Mesothelioma</i>, p. 13</ref> It was impossible for physicians to diagnosis accurately the condition without microscopes. The symptoms of asbestosis would have been readily apparent because it caused people severe difficulties in breathing. Alternatively, mesothelioma was fatal and it could be mistaken for other diseases such as tuberculous or other cancers.
====Mesothelioma Tumorswas first discovered in 1767====
In 1767, Joseph Lieutaud, a renowned French pathologist and King Louis XVI's personal physician, published 2 cases of "pleural tumors" in the <i>Précis de médecine pratique</i>. Leiutaud wrote that the pleural tumors consisted of finding "fleshy masses" adhering to "the pleura and ribs."<ref>Ed. Harvey I. Pass, Nicholas Vogelzang, & Michele Carbone, <i>Malignant Mesothelioma: Pathogenesis, Diagnosis, and Translational Therapies</i> (Springer, New York City, 2005), p. 13.</ref> The tumors described by Lieutaud resembled tumors now known to cause mesothelioma. A German pathologist, von Rokitansky, in 1854 identified tumors that he described as "tumors of the peritoneum" and called "colloid cancer." While he correctly described the tumors, he misidentified them. In 1870, another German doctor, E. Wagner, published a paper that accurately distinguished mesothelioma tumors from tuberculous. Using a microscope, he discovered that the patients that had been diagnosed with tuberculous actually had malignant tumors in the pleura.<ref>Ed. Pass, <i>Malifnant Mesothelioma</i></ref>
Slowly, physicians were beginning to successfully identify the tumors that caused mesothelioma. Because these types of tumors were exceeding rare, it was challenging for physicians to identify them. Finally, in 1920, Ernest S. Du Bray and F. B. Rosson coined the term "primary mesothelioma of the pleura" in an American medical Journal and traced the history of the pleura tumors up until that point. <ref>Du Bray, Ernest & F. B. Rosson, "Primary Mesothelioma of the Pleura: A Clinical and Pathologic Contribution to the Pleural Malignancy, with Report of a Case," <i> Arch Intern Med</i> (Chic), 1920 26(6): 715-737.</ref> Despite, Du Bray and Rosson's article, "doubting Thomases" still questioned whether pleura tumors were existed up until the late 1950s.<ref>ed. Tappapfel, <i>Malignant Mesothelioma</i> p. 14.</ref> Significantly, it took another 40 years for mesothelioma to be tied to the exposure to asbestos.
====Making When was mesothelioma first diagnosed by making the Connection connection between Pleura Tumors and Asbestos?====Finally in 1959, three South African physicians, J.C. Wagner, Kit Sleggs, and Paul Marchand published a medical paper linking the deadly form of cancer mesothelioma to asbestos.<ref>Wagner, J.C., Sleggs, C.A. and Marchand, P., "Diffuse pleural mesothelioma and asbestos exposure in the north western Cape Province, <i>BR.J.Ind.Med</i> 1960;17:260-71.</ref> In 1956, Dr. Wagner faced was confronted with a series of patients that appeared to be suffering from tuberculous and emphysema in and around Kimberely, South Africa. Once these patients were identified it was decided that these patients had the best chance to survive if they were sent to a tuberculous hospital managed by Dr. Kit Sleggs in Kimberly. These patients were brought in from an enormous area surrounding Kimberely (currently famous the enormous open pit diamond mine next to the town).  The doctors quickly learned that patients who lived east of Kimberely recovered from their illness, but patients who west of Kimberly did not respond and died. The physicians realized that the patients west of Kimberely were suffering from a different and far more dangerous disease than tuberculous or emphysema. After patients died, the autopsies showed that all of the patients from west of Kimberly suffered from extremely rare mesothelioma tumors.<ref>Wagner, J.C., "The discovery of the association between blue asbestos and mesotheliomas and the aftermath," <i>British Journal of Industrial Medicine</i>, 1991; 48:399-403</ref> The doctors realized it was unlikely that these tumors were simply random.
[[File:Open_pit_mine.jpg|thumbnail|300px|left|The Big Hole next to Kimberely, South Africa]]
A pathologist who worked with Wagner in Kimberly, informed Wagner and Kleggs that he had seen similar mesothelioma tumors in Johannesburg, South Africa. Kleggs and Wagner contacted Dr. Paul Marchand, the physician who had treated many of the Johannesburg patients. The three physicians immediately suspected that blue asbestos might of the tumors. After taking another look at the samples of lung from deceased patients, they found fragments of asbestos mineral. Initially, the physicians struggled to link asbestos and mesothelioma for two reasons: First, many of the patients (both black and white) denied working in asbestos mines. Second, mesothelioma tumors were typically fatal within a year or two within diagnosis, but these patients were developing tumors 10-20 years after their first exposure to asbestos. The physicians needed to establish that the tumors were not a result of some other source.  ====Patients did not like admitting that they worked with asbestos which made it hard to link it with Mesotheelioma====Eventually, the doctors realized that their patients had lied to them because their there was a social stigma attached to working with asbestos. The patients had worked in and around asbestos, but were loath reluctant to admit. Eventually, patients began to reveal that they had worked in asbestos mines or mills. In some cases, these patients described living in "a blue haze" in their communities that were located next to mines and mills. The mills and mines west of Kimberly worked with blue asbestos.<ref>Wagner, J.C., "The discovery of the association between blue asbestos and mesotheliomas and the aftermath," <i>British Journal of Industrial Medicine</i>, 1991; 48:399-403 and Tannapefel, <i>Malignant Mesothelioma</i>, p. 15.</ref>
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In order to To determine if asbestos was the cause, the physicians had an unlikely incredible resource. The South African Pneumoconiosis Bureau had to keep records and samples of the thoracic organs of most of the miners who had died. The South African government had already determined that working with asbestos was dangerous, but they did not know exactly precisely why. On the other hand, mining companies were not interested in delving too deeply into why their miners died. The physicians were allowed to review realized after reviewing these samples and learned that miners exposed to amosite (blue) and occasionally chrysolite asbestos developed fatal pleura tumors. After further study, it became clear that all types of asbestos could cause cancer, but some types of asbestos were much more dangerous. It was also confirmed that cigarette smokers who were exposed to asbestos faced even higher risks of developing mesothelioma.<ref>Wagner, J.C.,"The discovery of the association between blue asbestos and mesotheliomas and the aftermath," <i>British Journal of Industrial Medicine</i>, 1991; 48:399-403: 433.</ref>
Eventually, physicians would establish established that tradesmen that worked around asbestos were also exposed to enough to cause mesothelioma. Oftentimes Frequently in these cases, the disease would develop much later than those who worked in the mills or asbestos mines. Workers who built ships for the US Navy were often exposed to large amounts of asbestos because it was used to make the naval ship more fireproof.<ref>Tannapfel, <i>Malignant Mesothelioma</i>, p. 16. </ref>
====Conclusion====

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